Individual
DR. DOUGLASS EUGENE HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST
Contact information
Practice address
24 E MAIN ST, REXBURG, ID 83440-1927
(208) 356-0881
(208) 359-9680
Mailing address
24 E MAIN ST, PO BOX 547, REXBURG, ID 83440-1927
(208) 356-0881
(208) 359-9680
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
ODP 0703
ID
Other
Enumeration date
02/07/2007
Last updated
04/25/2012
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