Provider Demographics
NPI:1275718447
Name:M H HANSEN DPM PLC
Entity Type:Organization
Organization Name:M H HANSEN DPM PLC
Other - Org Name:CACTUS FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:H
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-889-2905
Mailing Address - Street 1:1880 W FRYE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6234
Mailing Address - Country:US
Mailing Address - Phone:480-889-2905
Mailing Address - Fax:480-889-2906
Practice Address - Street 1:1880 W FRYE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6234
Practice Address - Country:US
Practice Address - Phone:480-889-2905
Practice Address - Fax:480-889-2906
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M H HANSEN DPM PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-07
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ147685Medicare PIN
AZU90309Medicare UPIN
Z100466Medicare PIN
AZ6076280001Medicare NSC