Individual
DR. KATHLEEN LEE HANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
915 GORDON AVE, THOMASVILLE, GA 31792-6614
(229) 228-2000
Mailing address
920 US HIGHWAY 84 W, THOMASVILLE, GA 31792-0510
(229) 228-8857
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
056572
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000810851Y
—
GA
05
—
252662000
—
FL
Enumeration date
05/19/2006
Last updated
03/06/2008
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