Provider Demographics
NPI:1497717581
Name:HANSON, JOSEPH M (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:HANSON
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 1:5121 CARNOUSTIE CT
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1507
Mailing Address - Country:US
Mailing Address - Phone:412-279-3998
Mailing Address - Fax:
Practice Address - Street 1:575 LINCOLN AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-3550
Practice Address - Country:US
Practice Address - Phone:412-788-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE005645P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist