Individual
DR. CHARLES DOUGLAS HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 S CEDAR LN, PULASKI, TN 38478-3502
(931) 363-2511
(931) 424-6109
Mailing address
215 S CEDAR LN, P.O. BOX 577, PULASKI, TN 38478-3502
(931) 363-2511
(931) 424-6109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13533
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3189955
—
TN
Enumeration date
11/07/2005
Last updated
06/02/2010
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