Provider Demographics
NPI:1346274768
Name:HANSEN, ALAN R (OD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:HANSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 N MUR LEN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5401
Mailing Address - Country:US
Mailing Address - Phone:913-764-2020
Mailing Address - Fax:
Practice Address - Street 1:751 N MUR LEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5401
Practice Address - Country:US
Practice Address - Phone:913-764-2020
Practice Address - Fax:913-768-4422
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS 1136-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0001995Medicare PIN
KST73602Medicare UPIN
KS4369250001Medicare NSC