Individual
KYLE J HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6588
(770) 237-1723
Mailing address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6588
(770) 237-1723
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43771
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007
BCBS
WI
05
—
34318700
—
WI
Enumeration date
05/05/2006
Last updated
06/06/2008
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