Organization
CASEY HANNA MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN CASEY HANNA MD (OWNER)
(918) 485-5188
Entity
Organization
Contact information
Practice address
1202 W CHEROKEE ST STE E, WAGONER, OK 74467-4629
(918) 485-5188
(915) 485-5402
Mailing address
PO BOX 894, WAGONER, OK 74477-0894
(918) 485-5188
(918) 485-5402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21947
OK
Other
Enumeration date
12/11/2007
Last updated
07/22/2009
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