Kent O Hanson, MD, LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

KENT O HANSON, MD, LTD

Practice address

2601 N 3Rd St
Suite #308
Phoenix, AZ 85004-1104

Phone

(602) 264-5959

Fax

(602) 279-7433

NPI assigned

Sep 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kent Oscar Hanson, MD

Title

Owner

Phone

(602) 264-5359

Specialties & licenses 1

Addresses

Other identifiers 4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1174717136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 N 3RD ST",
            "address_2": "SUITE #308",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041104",
            "telephone_number": "602-264-5959",
            "fax_number": "602-279-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N 3RD ST",
            "address_2": "SUITE #308",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041104",
            "telephone_number": "602-264-5959",
            "fax_number": "602-279-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT O HANSON, MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "OSCAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-264-5359",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "1Z7476",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "2784",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "03D09311231",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0015000",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fredrick I. Kenny, M.D.
• Katherine J Kenny, ANP
• Meghan Kenny
• Robert E Kenrich, POD
• Anthony T Kenrick, MD
• Joshua John Kent
• Maria Joana Alcantara Kent, NP
• Martha Kent, PH.D.
• Meagan C Kent
• Nicolle Serena Kent, MD

• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.