Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 7192033-1204 | UT |
N | 207ND0101X | MOHS-Micrographic Surgeon | 7192033-1204 | UT |
N | 207ND0900X | Dermatopathologist | 7192033-1204 | UT |
N | 207NP0225X | Pediatric Dermatologist | 7192033-1204 | UT |
N | 207NS0135X | Procedural Dermatology | 7192033-1204 | UT |
NPI | 1114121217 |
---|---|
Provider Name | Dr. Daniel Joseph Hansen |
First Address | South Ogden, UT 84405-4976 |
Second Address | South Ogden, UT 84405-4976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 12/01/2016 |