Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 04-23119 | KS |
NPI | 1043287733 |
---|---|
Provider Name | Eric E. Hansen |
First Address | Topeka, KS 66614-4231 |
Second Address | Topeka, KS 66614-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 03/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100119540B | (05) | KS |
200111120A | (05) | OK |
200449601 | (05) | MO |
219322 | ANTHEM (01) | MO |
E52239 | (02) | |
P00403959 | RR MEDICARE (01) |