Organization
ERIC HANSEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC CHRISTOPHER HANSEN MD (OWNER)
(307) 789-8881
Entity
Organization
Contact information
Practice address
150 ARROWHEAD DR, SUITE 2, EVANSTON, WY 82930-9353
(307) 789-8881
(307) 789-6470
Mailing address
150 ARROWHEAD DR, SUITE 2, EVANSTON, WY 82930-9353
(307) 789-8881
(307) 789-6470
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6429A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119741000
—
WY
01
—
W310473
MEDICARE ID-TYPE UNSPECIFIED
WY
Enumeration date
06/07/2010
Last updated
07/14/2010
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