Organization
ANKENY FAMILY VISION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH RICHARD HANSEN O.D. (DOCTOR OF OPTOMETRY)
(515) 964-1671
Entity
Organization
Contact information
Practice address
311 N ANKENY BLVD, ANKENY, IA 50023-1711
(515) 964-1671
Mailing address
311 N ANKENY BLVD, ANKENY, IA 50023-1711
(515) 964-1671
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01592
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
DOCTORS SOCIAL
IA
01
—
01592
IOWA LICENSE NUMBER
IA
05
—
1142968
—
IA
01
—
1295730992
NPI TYPE I NUMBER
IA
01
—
DE6338
RAIL ROAD MEDICARE
IA
Enumeration date
05/23/2007
Last updated
03/07/2023
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