Individual
ARA JAMES HANISSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
574 GREEN TREE CV, SUITE 101, COLLIERVILLE, TN 38017-2562
(901) 853-2021
(901) 853-2434
Mailing address
574 GREEN TREE CV, SUITE 101, COLLIERVILLE, TN 38017-2562
(901) 853-2021
(901) 853-2434
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
29057
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4031484
BCBS PROVIDER ID
TN
Enumeration date
11/27/2006
Last updated
01/26/2010
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