Individual
DR. BROCK C HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4360 WASHINGTON BLVD, OGDEN, UT 84403-1866
(801) 476-0494
(801) 479-3937
Mailing address
PO BOX 30015, DPT 93, SALT LAKE CITY, UT 84130-0015
(801) 476-0494
(801) 479-3937
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
11197395-1205
UT
207WX0120X
Cornea and External Diseases Specialist Physician
11197395-1205
UT
Other
Enumeration date
04/02/2014
Last updated
03/26/2019
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