Individual
GEORGE DUGGAN HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 993-9551
(801) 733-5872
Mailing address
12623 E GUARDSMAN PASS RD, BRIGHTON, UT 84121-9729
(435) 615-1280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
177450-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107006884101
IHC
UT
01
—
2000040
UNITED HEALTHCARE
UT
01
—
2373
HEALTHY U
UT
01
—
28154
PEHP
UT
05
—
401765
—
MT
01
—
416936
DESERET MUTUAL
UT
05
—
832106
—
AZ
01
—
870280408HA1
EDUCATORS MUTUAL
UT
01
—
PR00872
MOLINA
UT
01
—
QM0000049521
ALTIUS
UT
Enumeration date
08/24/2006
Last updated
07/08/2007
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