Individual
DR. MARK C HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4140 TATE ST NE, COVINGTON, GA 30014-2562
(770) 786-0077
(770) 786-8750
Mailing address
4140 TATE ST NE, COVINGTON, GA 30014-2562
(770) 786-0077
(770) 786-8750
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30469
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00408614F
—
GA
05
—
00408614G
—
GA
Enumeration date
05/12/2006
Last updated
12/01/2011
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