Individual
DR. DALE E HANSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 726-7358
Mailing address
7695 POPLAR PIKE 101, GERMANTOWN, TN 38138-5947
(901) 685-2696
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
19276
TN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
19276
TN
2085R0204X
Vascular & Interventional Radiology Physician
20234
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3043279
—
TN
Enumeration date
05/24/2005
Last updated
08/02/2016
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