Individual
THOMAS L HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 4TH ST S STE 612, FARGO, ND 58103-1940
(701) 235-0561
(701) 235-0330
Mailing address
100 4TH ST S STE 612, FARGO, ND 58103-1940
(701) 235-0561
(701) 235-0330
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
29226
MN
207W00000X
Ophthalmology Physician
Primary
4870
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11357
BLUE SHIELD
ND
05
—
14255
—
ND
01
—
2M042HA
BLUE SHIELD
MN
01
—
892822
VISION SERVICES
ND
Enumeration date
10/11/2006
Last updated
07/08/2007
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