Jason Matthew Hanson in Bridgeton - Specialist
Jason Matthew Hanson - NPI 1063522597
Jason Matthew Hanson is a Specialist in Bridgeton, Missouri. Jason Matthew Hanson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jason Matthew Hanson is 1063522597. The last update date is 2019-10-15.
Jason Matthew Hanson's current location address is 12255 De Paul Dr Ste 830n, Bridgeton, Missouri. You can contact this provider via phone number 3142915307 and fax number 3142910838. The mailing address for Jason Matthew Hanson is 12255 De Paul Dr Ste 830n, Bridgeton, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jason Matthew Hanson |
|---|---|
| Address | 12255 De Paul Dr Ste 830n, Bridgeton, Missouri |
| Phone Number | 3142915307 |
| Fax Number | 3142910838 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1063522597 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2019-10-15 |
Provider Mailing Address Detail
| Address | 12255 De Paul Dr Ste 830n |
|---|---|
| City | Bridgeton |
| State | Missouri (MO) |
| Post Code | 630442510 |
| Phone Number | 3142915307 |
| Fax Number | 3142910838 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 103004 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2013172 | MO | PTAN |
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What is the Jason Matthew Hanson's unique identification number?
The Jason Matthew Hanson has been assigned the NPI (National Provider Identifier) Number 1063522597 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Jason Matthew Hanson located?
The Jason Matthew Hanson is located at 12255 De Paul Dr Ste 830N, Bridgeton, MO 630442510.
What is the Jason Matthew Hanson's specialty and taxonomy code?
The Jason Matthew Hanson's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Jason Matthew Hanson receive its 1063522597 assignment from the Centers for Medicare & Medicaid Services?
The Jason Matthew Hanson was assigned its 1063522597 by the Centers for Medicare & Medicaid Services on 2006-08-30.
When was the information regarding Jason Matthew Hanson most recently updated?
The details pertaining to the Jason Matthew Hanson, including its address, specialty, and other relevant information, were last refreshed on 2019-10-15.
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