OrganizationActive
Dwayne M. Hansen MD PLLC
NPI 1114024650 · Surgery Physician · Rexburg, ID
Provider details
- NPI number
- 1114024650
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dwayne Hansen, Owner(208) 656-8442
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
381 East 4th North Street
Suite 100
Rexburg, ID 83440
Phone: (208) 656-8442
Fax: (208) 656-8453
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 185
Rexburg, ID 83440-0185
Registry dates
- Enumerated
- 2006-09-19
- Last updated
- 2007-12-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.