Individual
JAMIE N HANNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2118 25TH ST STE E, COLUMBUS, IN 47201-3240
(812) 373-2700
(812) 373-2710
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01066408A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200473750
—
IN
Enumeration date
08/25/2005
Last updated
09/09/2024
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