Hanson, Theodore J

Hanson, Theodore J is an individual health care provider with primary practice located at 1000 1St Dr Nw , Austin MN 55912-2941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Hanson, Theodore J can be contacted via phone (507) 433-7351.

Contact Information

Primary practice address
1000 1St Dr Nw Austin MN 55912-2941
Phone: (507) 433-7351
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 68648-20 Wisconsin
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 56567 Minnesota

Profile Details

NPI number 1417211483
LBN Legal business name Hanson, Theodore J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2012
Last updated Jul 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417211483 NPPES
Iowa MEDICAID ENROLLED
Iowa MEDICAID ENROLLED

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