Individual
DR. DEBORAH I HANSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
405 ALABAMA AVE, BREMEN, GA 30110-2005
(770) 537-2367
(770) 537-1203
Mailing address
132 OLE HICKORY TRAIL, CARROLLTON, GA 30117
(770) 830-1164
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
023292
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00609738A
—
GA
Enumeration date
07/05/2006
Last updated
02/01/2019
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