Provider Demographics
NPI:1932328978
Name:HANSON, ROBERT ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:HANSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 N DOBSON RD STE C48
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4232
Mailing Address - Country:US
Mailing Address - Phone:480-899-9430
Mailing Address - Fax:480-899-9554
Practice Address - Street 1:595 N DOBSON RD STE C48
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4232
Practice Address - Country:US
Practice Address - Phone:480-899-9430
Practice Address - Fax:480-899-9554
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315022261207RC0000X, 207R00000X
AZ006614207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1932328978Medicaid