Hanson, Mark C
Hanson, Mark C is an individual health care provider with primary practice located at 4140 Tate St Ne , Covington GA 30014-2562. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Hanson, Mark C can be contacted via phone (770) 786-0077.Contact Information
Primary practice address
4140 Tate St Ne
Covington GA 30014-2562
Phone: (770) 786-0077
Fax: (770) 786-8750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 30469 | Georgia |
Profile Details
| NPI number | 1265483663 |
|---|---|
| LBN Legal business name | Hanson, Mark C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Dec 1st, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265483663 | NPPES |
| Georgia | MEDICAID | 00408614G | |
| Georgia | MEDICAID | 00408614F |
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