Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 8180 | AL |
NPI | 1639117526 |
---|---|
Provider Name | Dr. Charles R. Hanes II |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-1541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 30/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
149455 | (05) | AL |
C74797 | (02) | AL |