Individual
DR. REGAN BENNETT HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Mailing address
320 WARNER DRIVE, LEWISTON, ID 83501
(208) 743-3523
(208) 746-8741
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M7862
ID
207X00000X
Orthopaedic Surgery Physician
MD00037759
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10005614
REGENCE
ID
01
—
33399
BLUE CROSS OF IDAHO
ID
05
—
805498200
—
ID
05
—
8245110
—
WA
Enumeration date
09/14/2005
Last updated
06/24/2016
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