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:
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Health care specialties

SpecialtyCodeLicense #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 13 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 1265483663 NPPES
Georgia MEDICAID 00408614G
Georgia MEDICAID 00408614F

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