Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 1871 | OK |
NPI | 1083684302 |
---|---|
Provider Name | Christian S Hanson |
First Address | Tulsa, OK 74133-5718 |
Second Address | Tulsa, OK 74133-5718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 04/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100118080A | (05) | OK |
460003326 | MEDICARE RAILROAD (01) | OK |
D38543 | (02) | OK |
OK400802 | MEDICARE PTAN (01) | OK |
P00613414 | MEDICARE RAILROAD (01) | OK |