Individual
DR. BRADY P. HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1607 SAINT JAMES CT, TALLAHASSEE, FL 32308-5352
(850) 878-0191
(850) 878-8900
Mailing address
1607 SAINT JAMES CT, TALLAHASSEE, FL 32308-5352
(850) 878-0191
(850) 878-8900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003296A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368674
ANTHEM BCBS
IN
01
—
003
DAVIS VISION
IN
01
—
0356760001
DMERC
IN
01
—
200517920
CORESOURCE
IN
05
—
200517920
—
IN
Enumeration date
10/05/2005
Last updated
10/11/2012
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