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Individual

TIMOTHY EARL HANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3860 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 828-1010
(505) 796-9051
Mailing address
3860 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 828-1010
(505) 796-9051

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
A-964-99
NM
208VP0000X
Pain Medicine Physician
Primary
A-964-99
NM

Other

Enumeration date
06/16/2006
Last updated
07/18/2013
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