Individual
DR. TIMOTHY B. HANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3830 W FRONT ST, TRAVERSE CITY, MI 49684-8153
(231) 929-3888
(231) 929-4365
Mailing address
3830 W FRONT ST, TRAVERSE CITY, MI 49684-8153
(231) 929-3888
(231) 929-4365
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301048021
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020070001
DMERC REG B
MI
05
—
103164508
—
MI
01
—
180018787
RAILROAD MEDICARE
MI
01
—
180B86357
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/06/2005
Last updated
01/15/2010
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