Hanley, Roger D

Hanley, Roger D is an sole proprietor health care provider with primary practice located at 5005 Sw Malcom Rd , Lawton OK 73505-9701. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Hanley, Roger D can be contacted via phone (580) 536-4141.

Contact Information

Primary practice address
5005 Sw Malcom Rd Lawton OK 73505-9701
Phone: (580) 536-4141
Fax: (580) 536-4242
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 33243 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R0030656 Oklahoma

Profile Details

NPI number 1588656235
LBN Legal business name Hanley, Roger D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Feb 6th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588656235 NPPES
Oklahoma MEDICAID 100781660A

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