Individual
LEE C HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 499-8137
Mailing address
PO BOX 285, FORT MEADE, SD 57741-0285
(605) 499-8137
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2001010350
MO
207R00000X
Internal Medicine Physician
Primary
2001010350
MO
208M00000X
Hospitalist Physician
2001010350
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205348006
—
MO
Enumeration date
02/02/2006
Last updated
05/14/2015
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