Individual
DR. MARK T HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 N 500 E, LOGAN, UT 84341-2400
(435) 716-1950
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
358614-1205
UT
208600000X
Surgery Physician
71681
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107008361102
IHC
UT
01
—
344470
DMBA
UT
01
—
48410
PEHP
UT
01
—
870591755HA1
EMIA
UT
Enumeration date
02/03/2006
Last updated
11/11/2025
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