Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 5226 | AL |
Y | 213EG0000X | General Practice | 5226 | AL |
NPI | 1003822545 |
---|---|
Provider Name | Dr. Lance Christopher Hankinson |
First Address | Semmes, AL 36575-7409 |
Second Address | Mobile, AL 36602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 14/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009905715 | (05) | AL |
14048 | BCBS (01) | AL |
1445292 | UNITED CONCORDIA (01) | AL |