Individual
DR. DALLAS GREGORY HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(937) 679-6276
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5506
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101248965
VA
208600000X
Surgery Physician
Primary
35132197
OH
2086S0127X
Trauma Surgery Physician
35132197
OH
Other
Enumeration date
06/02/2009
Last updated
04/06/2022
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