Individual
DR. STEPHANIE B. HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 261-5151
Mailing address
PO BOX 731280, DALLAS, TX 75373-1280
(318) 841-9532
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
020858
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1674095
—
LA
01
—
220031201
RAILROAD MEDICARE
LA
Enumeration date
10/03/2005
Last updated
04/04/2012
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