Individual
DR. MARK HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 PROSPECT AVE, ESTES PARK, CO 80517-6312
(970) 586-2200
(970) 577-4338
Mailing address
555 PROSPECT AVE, ESTES PARK, CO 80517-6312
(970) 586-2317
(970) 577-4338
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34683
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01346832
—
CO
Enumeration date
09/20/2005
Last updated
04/21/2011
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