Individual
JONATHAN B HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1373 E STATE ROAD 62 STE 2E, MADISON, IN 47250-7328
(812) 801-0820
(812) 801-0027
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01060659
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200517770C
—
IN
05
—
64100803
—
KY
Enumeration date
07/03/2006
Last updated
10/09/2025
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