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Individual

DR. KIRK HANSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
600 WALNUT RIDGE DR, HARTLAND, WI 53029-9385
(262) 369-6902
(262) 369-6922
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11016285A
IN
207Q00000X
Family Medicine Physician
Primary
62860
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100040118
WI
Enumeration date
08/08/2011
Last updated
12/11/2023
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