Organization
MAX HANSEN SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE MAXWELL HANSEN JR. DO (DOCTOR OF OSTEOPATH - SURGEON)
(208) 656-8442
Entity
Organization
Contact information
Practice address
381 E 4TH N STE 100, REXBURG, ID 83440-1684
(208) 656-8442
(208) 656-8453
Mailing address
PO BOX 185, REXBURG, ID 83440-0185
(208) 656-8442
(208) 656-8453
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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