Individual
KENNETH C. HANSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 COOPER AVE, SAGINAW, MI 48602-5182
(989) 583-6521
Mailing address
7905 E CURTIS RD, FRANKENMUTH, MI 48734-9583
(262) 245-2248
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01054195A
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036-141304
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
65793-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198747
BLUE CROSS/BLUE SHIELD
IN
01
—
000000640498
BC/BS
IN
01
—
000000668240
ANTHEM BC/BS
IN
01
—
1295734135
BCBSWI
WI
05
—
1295734135
—
WI
05
—
200336440A
—
IN
01
—
HANSOKEN
MERCYCARE INSURANCE
WI
01
—
P00023838
RAIL ROAD
IN
01
—
P00775286
RAILROAD MEDICARE
IN
01
—
P00841040
RAILROAD MEDICARE
IN
Enumeration date
07/20/2005
Last updated
03/26/2021
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