Individual
DR. TERRY WAYNE HANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1027 BATEMAN DR, SUITE B, SOCIAL CIRCLE, GA 30025-5025
(770) 464-2048
(770) 464-9995
Mailing address
703 STERLING WATER CT, MONROE, GA 30655-7707
(770) 266-7954
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
047330
GA
Other
Enumeration date
10/19/2005
Last updated
07/08/2007
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