Provider Demographics
NPI:1083754378
Name:KARA HANSON OD PC
Entity Type:Organization
Organization Name:KARA HANSON OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-388-7000
Mailing Address - Street 1:10170 E MISSISSIPPI AVE
Mailing Address - Street 2:ALLCARE BUILDING
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2418
Mailing Address - Country:US
Mailing Address - Phone:303-388-7000
Mailing Address - Fax:
Practice Address - Street 1:10170 E MISSISSIPPI AVE
Practice Address - Street 2:ALLCARE BUILDING
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2418
Practice Address - Country:US
Practice Address - Phone:303-388-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2473152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710980172OtherINDIVIDUAL NPI
803236Medicare ID - Type Unspecified