Individual
SYED GHAZANFAR HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
ETSU PSYCHIATRY AND BEHAVIORAL SCIENCES DEPARTMENT, 1276 GILBREATH DR., JOHNSON CITY, TN 37604
(423) 439-8000
Mailing address
PO BOX 70567, JOHNSON CITY, TN 37614-1707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036161432
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2018
Last updated
10/03/2022
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