# HANNA MEDICAL CLINIC SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902342868
- **Authorized official:** DR. NICKOLAS HANNA MD (OWNER)
- **Authorized official phone:** (608) 208-8022

## Contact information

- **Practice address:** 3207 LAURA LN STE 105, MIDDLETON, WI 53562-1428
- **Practice address phone:** (608) 203-8022
- **Practice address fax:** (608) 203-8041
- **Mailing address:** 3207 LAURA LN STE 105, MIDDLETON, WI 53562-1428
- **Mailing address phone:** (608) 203-8022
- **Mailing address fax:** (608) 203-8041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 01/16/2017
- **Last updated:** 11/08/2023