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NPI Code Detail

MEDICARE: TIMOTHY STEVENS HANES M.D.

MEDICARE: TIMOTHY STEVENS HANES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician047758GA

General Provider Information

NPI Number : 1104804301
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY STEVENS HANES M.D.
Provider Business Mailing Address
First Line : PO BOX 3157
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-3157
Country : US
Telephone Number : 770-405-2976
Fax Number :
Provider Business Practice Location Address
First Line : 790 CHURCH ST NE STE 400
Second Line :
City : MARIETTA
State : GA
Zip : 30060-8957
Country : US
Telephone Number : 770-405-2976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 02/28/2024

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Directions to “ TIMOTHY STEVENS HANES M.D.” Practice Location

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