Provider Demographics
NPI:1326485202
Name:HANSEN, KRISTOPHER JOEL (DO)
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:JOEL
Last Name:HANSEN
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 1:800 HOWARD AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4728
Mailing Address - Country:US
Mailing Address - Phone:814-889-2708
Mailing Address - Fax:
Practice Address - Street 1:800 HOWARD AVE STE 1
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4728
Practice Address - Country:US
Practice Address - Phone:814-889-2708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS022580207RX0202X
NC2021-01694207RX0202X
MI5101027128207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology