Doctor Name: | DR. MARK HANSEN |
NPI Number: | 1215923842 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 34683 |
Business Practice Address: | 555 Prospect Ave Estes Park, CO - 805176312 |
Business Phone Number: | 9705862200 |
Business Fax Number: | 9705774338 |
Mailing Address: | 555 Prospect Ave, ESTES PARK |
State: | CO |
Postal Code: | 805176312 |
Phone Number: | 9705862317 |
Fax Number: | 9705774338 |
NPI Enumeration Date: | 09/20/2005 |
NPI Last Update Date: | 04/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 34683 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |