Douglass Eugene Hanson, OPTOMETRIST

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

ODP 0703 Issued in ID

Practice address

24 E Main St
Rexburg, ID 83440-1927

Phone

(208) 356-0881

Fax

(208) 359-9680

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1225178593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 E MAIN ST",
            "address_2": "PO BOX 547",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401927",
            "telephone_number": "208-356-0881",
            "fax_number": "208-359-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401927",
            "telephone_number": "208-356-0881",
            "fax_number": "208-359-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DOUGLASS",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "ID",
            "license": "ODP 0703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryant Hansen, PA-C
• David Victor Hansen, M.D.
• Dwayne M Hansen, M.D.
• Dwayne Maxwell Hansen Jr., DO
• Hanson Group LLC
• Troy Hanson, NP
• Rosemarie Ellen Hardin
• Scott Russell Hardy, D.O.
• David Thomas Hargraves, PH.D.
• Tyler Harrigfeld, DPT

• Corneal and Contact Management Optometrist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Corneal and Contact Management Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.