Hanson, Ray William

Hanson, Ray William is an sole proprietor health care provider with primary practice located at 2325 Coronado St , Idaho Falls ID 83404-7407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Hanson, Ray William can be contacted via phone (208) 557-2700.

Contact Information

Primary practice address
2325 Coronado St Idaho Falls ID 83404-7407
Phone: (208) 557-2700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M-9006 Idaho

Profile Details

NPI number 1861440513
LBN Legal business name Hanson, Ray William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2006
Last updated Jun 3rd, 2014 - about 12 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 1861440513 NPPES
Idaho Other B4851 BLUE CROSS OLD
Idaho Other HB399 BLUE CROSS OLD
Idaho Other 313058 BLUE CROSS OLD
Idaho MEDICAID 807127000 BLUE CROSS OLD

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