Individual
DR. RUSSELL LEON HANAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 NW 13TH ST, OKLAHOMA CITY, OK 73103
(405) 235-3245
(405) 235-6991
Mailing address
400 NW 13TH ST, OKLAHOMA CITY, OK 73103
(405) 235-3245
(405) 235-6991
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10300
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100105740A
—
OK
Enumeration date
03/14/2006
Last updated
06/23/2010
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