Provider Demographics
NPI:1649561713
Name:HANSON, CHAD (DO)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:HANSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5310 E 31ST ST STE 13
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5013
Mailing Address - Country:US
Mailing Address - Phone:918-561-5701
Mailing Address - Fax:918-561-1173
Practice Address - Street 1:744 W 9TH ST FL 1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9907
Practice Address - Country:US
Practice Address - Phone:918-631-8877
Practice Address - Fax:918-631-8875
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK5224207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200700820BMedicaid
OK2G4537OtherMEDICARE
OK7B7340OtherMEDICARE