Individual
WILSON T. HANNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 483-0011
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
256537
MA
207RI0011X
Interventional Cardiology Physician
Primary
32148
MS
208M00000X
Hospitalist Physician
303206
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06374764
—
MS
05
—
2431188
—
LA
Enumeration date
06/05/2013
Last updated
10/09/2023
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