Provider Demographics
NPI:1275752461
Name:LINDSAY HANSEN M D CHARTERED
Entity Type:Organization
Organization Name:LINDSAY HANSEN M D CHARTERED
Other - Org Name:LINDSAY T HANSEN MD CHTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-240-8111
Mailing Address - Street 1:9940 W FLAMINGO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8553
Mailing Address - Country:US
Mailing Address - Phone:702-240-8111
Mailing Address - Fax:702-240-1940
Practice Address - Street 1:9940 W FLAMINGO RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8553
Practice Address - Country:US
Practice Address - Phone:702-240-8111
Practice Address - Fax:702-240-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8106207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCB2821OtherRAILROAD MEDICARE
NV34257Medicare ID - Type UnspecifiedMEDICARE BILLING ID