Provider Demographics
NPI:1194700575
Name:HANSEL, KEVAN RICHARD (MD)
Entity type:Individual
Prefix:MR
First Name:KEVAN
Middle Name:RICHARD
Last Name:HANSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:828-693-3344
Mailing Address - Fax:828-692-2487
Practice Address - Street 1:1824 PISGAH DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3759
Practice Address - Country:US
Practice Address - Phone:828-694-8427
Practice Address - Fax:828-694-8424
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0301121207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
030455058OtherCRESENT
SCN0112AMedicaid
O104246OtherUNITED HEALTHCARE
611186890OtherPRIVATE HEALTHCARE SAVING
NCNC4940COtherMEDICARE
611186890OtherCRESENT
NC89135A7Medicaid
NCNC4940COtherMEDICARE PTAN
030455058OtherHEALTHCARE SAVINGS
611186890OtherCIGNA HEALTHCARE
104250OtherUNITED HEALTHCARE
354567600OtherOWCP
611186890OtherHUMANA TRICARE
611186890OtherBEECH STREET
611186890OtherHEALTHCARE SAVINGS
C9476OtherMEDCOST
NCP01403705OtherMEDICARE RR
NC135A7OtherBCBS
C9965OtherMEDCOST
611186890OtherFIRST HEALTH