Provider Demographics
NPI:1083614648
Name:HANST, CURTIS K (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:K
Last Name:HANST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2371 NE STEPHENS ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-1399
Mailing Address - Country:US
Mailing Address - Phone:541-672-8533
Mailing Address - Fax:541-672-4993
Practice Address - Street 1:2371 NE STEPHENS ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-1399
Practice Address - Country:US
Practice Address - Phone:541-672-8533
Practice Address - Fax:541-672-4993
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG88068207Q00000X
ORMD21163207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR165772Medicaid
CA00G88068Medicaid
OR165772Medicaid