Individual
DR. STEFAN HANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6436 E. FLORIDA STREET, SUITE 102, EVANSVILLE, IN 47715
(812) 200-8112
(812) 200-2823
Mailing address
PO BOX 8115, EVANSVILLE, IN 47716-8115
(812) 200-8112
(812) 200-2823
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004134A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300019943
—
IN
Enumeration date
10/08/2018
Last updated
03/20/2023
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