Individual
ROGER D HANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5005 SW MALCOM RD, LAWTON, OK 73505-9701
(580) 536-4141
(580) 536-4242
Mailing address
5005 SW MALCOM RD, LAWTON, OK 73505-9701
(580) 536-4141
(580) 536-4242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
33243
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
R0030656
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100781660A
—
OK
Enumeration date
08/18/2005
Last updated
02/06/2021
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