Individual
MARTIN A HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3730 S PINNACLE HILLS PKWY STE 2, ROGERS, AR 72758-8897
(479) 464-5599
(479) 464-5598
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3067
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146500001
—
AR
Enumeration date
08/09/2005
Last updated
08/12/2024
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