Individual
JOHN GREGORY HANSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13907 W CAMINO DEL SOL, SUITE 101, SUN CITY WEST, AZ 85375-4405
(623) 584-4695
(623) 298-6708
Mailing address
13907 W CAMINO DEL SOL, SUITE 101, SUN CITY WEST, AZ 85375-4405
(623) 584-4695
(623) 298-6708
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24172
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z5256
HEALTHNET OF AZ
AZ
01
—
340018047
RAILROAD MEDICARE
AZ
05
—
434712
—
AZ
01
—
AZ0867880
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
07/19/2006
Last updated
07/08/2007
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