Individual
DR. JAY HOWARD HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1739 W SUNSET BLVD, ST GEORGE, UT 84770-7141
(435) 634-6000
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11419832-1205
UT
207Q00000X
Family Medicine Physician
M10335
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1741389
—
IA
Enumeration date
09/17/2006
Last updated
07/20/2021
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