1275718447 NPI number — M H HANSEN DPM PLC

Table of content: (NPI 1275718447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275718447 NPI number — M H HANSEN DPM PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M H HANSEN DPM PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CACTUS FOOT AND ANKLE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275718447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1880 W FRYE RD
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85224-6234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-889-2905
Provider Business Mailing Address Fax Number:
480-889-2906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1880 W FRYE RD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224-6234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-889-2905
Provider Business Practice Location Address Fax Number:
480-889-2906
Provider Enumeration Date:
01/07/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HANSEN
Authorized Official First Name:
MYRON
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
480-889-2905

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)