Individual
CARL L HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
333 STATE ST, SUITE 204, ERIE, PA 16507-1450
(814) 877-5295
(814) 877-5299
Mailing address
333 STATE ST STE 104, ERIE, PA 16507-1463
(724) 933-0300
(724) 933-0456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA058564
PA
363A00000X
Physician Assistant
OA003917
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110458261
—
PA
Enumeration date
09/28/2016
Last updated
10/05/2022
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