IndividualActive
Dwayne Hansen, DO
NPI 1871013938 · Surgery Physician · Rexburg, ID
Provider details
- NPI number
- 1871013938
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
- License
- RL14661 (ND)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
381 E 4th N Ste 100
Rexburg, ID 83440-1684
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
- 2017-06-20
- Last updated
- 2025-06-11
- Certified
- 2025-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.