IndividualActive
Douglass Hanson, OPTOMETRIST
NPI 1225178593 · Corneal and Contact Management Optometrist · Rexburg, ID
Provider details
- NPI number
- 1225178593
- Entity type
- Individual
- Primary specialty
- Corneal and Contact Management OptometristEye and Vision Services Providers
- Credential
- OPTOMETRIST
- Sex
- Male
- Sole proprietor
- Yes
- License
- ODP 0703 (ID)
Practice location
24 E Main St
Rexburg, ID 83440-1927
Phone: (208) 356-0881
Fax: (208) 359-9680
Mailing address
24 E Main St
Rexburg, ID 83440-1927
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2012-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.