Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 80165 | MS |
NPI | 1407922867 |
---|---|
Provider Name | Scott Joseph Hanegan |
First Address | Meridian, MS 39301-3223 |
Second Address | Meridian, MS 39301-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 20/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
730-15591 | BCBS OF ALABAMA (01) | MS |
P00238726 | MEDICARE RAILROAD (01) | MS |
U80553 | (02) | MS |