Randall Tyler Hansen, DO Valid NPI

Individual provider · Family Medicine Physician · Provo, UT

NPI

1831459361

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

8699702-1204 (UT)

Sex

Male

Sole proprietor

No

Enumerated

2012-05-17

Last updated

2016-01-22