Individual
DR. BONNIE VANSCHOONEVELD HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2001 N PATTERSON ST, VALDOSTA, GA 31602-2944
(229) 245-0447
(229) 245-0448
Mailing address
3024 WENDOVER RD, VALDOSTA, GA 31602-1313
(229) 245-0447
(229) 245-0448
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
041132
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00707539C
—
GA
Enumeration date
04/26/2007
Last updated
10/20/2010
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