Individual
MICHAEL STEPHEN HANKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E PRIMROSE, STE 320, SPRINGFIELD, MO 65807
(417) 269-2300
(417) 269-2315
Mailing address
1000 E PRIMROSE, STE 320, SPRINGFIELD, MO 65807
(417) 269-2300
(417) 269-2315
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MRD1G32
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13538
BLUE CROSS BLUESHIELD
MO
Enumeration date
09/28/2005
Last updated
07/08/2007
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