Individual
MR. BRUCE M HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1055 N. CURTIS ROAD, BOISE, ID 83706-1309
(208) 367-2559
(770) 701-6675
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02003137A
IN
207L00000X
Anesthesiology Physician
9528888-1204
UT
207L00000X
Anesthesiology Physician
Primary
O-0636
ID
Other
Enumeration date
05/06/2008
Last updated
11/03/2025
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