Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD048635L | PA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 050633 | GA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 50633 | GA |
NPI | 1326159120 |
---|---|
Provider Name | Dr. Karla K. Hansen |
First Address | Brunswick, GA 31520-4722 |
Second Address | Brunswick, GA 31520-4271 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 01/08/2012 |