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DAVID JEFFREY HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
105 GRAND CENTRAL BLVD STE 108, POOLER, GA 31322-4148
(912) 748-1515
(844) 807-3782
Mailing address
105 GRAND CENTRAL BLVD STE 108, POOLER, GA 31322-4148
(912) 748-1515
(208) 625-2070

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1806
ID
363AM0700X
Medical Physician Assistant
Primary
12647
GA
363AM0700X
Medical Physician Assistant
PA1806
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12647
GA MEDCAL BOARD PA LICENSE
GA
01
PA1806
LICENSE
ID
Enumeration date
10/18/2019
Last updated
12/18/2024
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