Individual
DR. DWAYNE MAXWELL HANSEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
381 E 4TH N STE 100, REXBURG, ID 83440-1684
(208) 656-8442
(208) 656-8453
Mailing address
PO BOX 185, REXBURG, ID 83440-0185
(208) 656-8442
(208) 656-8453
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
O-1663
ID
208600000X
Surgery Physician
RL14661
ND
Other
Enumeration date
06/20/2017
Last updated
06/11/2025
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