Individual
JON C HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
96 E KIMBALLS LN STE 207, DRAPER, UT 84020-5025
(801) 576-2300
(801) 576-2399
Mailing address
PO BOX 100253, ATLANTA, GA 30384-0253
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA058073
PA
363AS0400X
Surgical Physician Assistant
Primary
14260704-1206
UT
Other
Enumeration date
01/20/2016
Last updated
05/07/2026
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