Individual
KENNETH D HANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
3420 JACKSON ST, SUITE E, OSHKOSH, WI 54901-8144
(920) 426-2211
(920) 426-2231
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47809020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34649900
—
WI
Enumeration date
05/16/2006
Last updated
07/08/2007
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