Provider Demographics
NPI:1174524003
Name:HASSAN, RIZWAN U (MD)
Entity type:Individual
Prefix:DR
First Name:RIZWAN
Middle Name:U
Last Name:HASSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1197
Mailing Address - Country:US
Mailing Address - Phone:620-669-2500
Mailing Address - Fax:620-694-2102
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1197
Practice Address - Country:US
Practice Address - Phone:620-694-4194
Practice Address - Fax:620-694-2128
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-186012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100123370IMedicaid
KS100123370DMedicaid
KS100123370BMedicaid
KSP01099862Medicare PIN
KSP01040104Medicare PIN
KSKA1853002Medicare PIN
KS100123370DMedicaid
KS024856Medicare ID - Type UnspecifiedPHYSICAN
KS100123370BMedicaid
KS110909Medicare PIN