Individual
DR. MARK D HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
315 PARHAM ST, SUITE B, MUSCATINE, IA 52761-2604
(563) 263-7577
(563) 263-7814
Mailing address
315 PARHAM ST, SUITE B, MUSCATINE, IA 52761-2604
(563) 263-7577
(563) 263-7814
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1742
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189936
—
IA
01
—
18993
WELLMARK BLUE CROSS
IA
01
—
410016371
RR MEDICARE
IA
Enumeration date
04/20/2006
Last updated
11/11/2014
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