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Individual

RANCIE WAYNE HANNAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1101 SAINT CHRISTOPHER DR, SUITE 250, ASHLAND, KY 41101-7087
(606) 836-3196
(606) 836-2564
Mailing address
1101 SAINT CHRISTOPHER DR, SUITE 250, ASHLAND, KY 41101-7087
(606) 836-3196
(606) 836-2564

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36544
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000199568
BLUE CROSS BLUE SHIELD
05
2204836
OH
05
64044704
KY
Enumeration date
07/07/2005
Last updated
10/17/2012
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