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Organization

BURNETT HANSON MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BURNETT HANSON M.D. (PRESIDENT)
(770) 429-1411
Entity
Organization

Contact information

Practice address
1501 ASTON AVE, MCCOMB, MS 39648-2734
(770) 429-1411
(770) 429-1951
Mailing address
P BOX 95305, GRAPEVINE, TX 76099-9734
(770) 429-1411

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18348
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DB0903
RAILROAD MEDICARE
MS
Enumeration date
07/10/2007
Last updated
03/19/2014
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