Individual
BRENT PAUL HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6320 W UNION HILLS DR STE 1800, GLENDALE, AZ 85308-1372
(480) 420-0749
(480) 420-0732
Mailing address
6320 W UNION HILLS DR STE 1800, GLENDALE, AZ 85308-1372
(480) 420-0749
(480) 420-0732
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
4183
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
937732
—
AZ
Enumeration date
01/30/2006
Last updated
09/04/2019
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