Individual
ERIC A HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 COSHOCTON AVE, MOUNT VERNON, OH 43050
(740) 393-9000
(740) 392-0167
Mailing address
1330 COSHOCTON AVE, MOUNT VERNON, OH 43050
(740) 393-9000
(740) 392-0167
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35073065
OH
207Q00000X
Family Medicine Physician
Primary
35.073065
OH
207Q00000X
Family Medicine Physician
35073065
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000187190
BCBS
—
05
—
2043443
—
OH
01
—
P00149373
RR MCR
—
01
—
P01243229
RAILROAD MEDICARE
OH
Enumeration date
08/21/2006
Last updated
03/05/2021
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