MEDICARE: EISSA HANNA 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
1	207W00000X	Ophthalmology Physician	MD60284655	WA
2	207W00000X	Ophthalmology Physician	20619	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194989996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EISSA HANNA M.D.

Provider Business Mailing Address
First Line	:	653 N TOWN CENTER DR STE 212
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0516
Country	:	US
Telephone Number	:	702-982-1360
Fax Number	:	702-202-3489

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR STE 212
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0516
Country	:	US
Telephone Number	:	702-982-1360
Fax Number	:	702-202-3489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2008
Last Update Date	:	12/10/2024

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Directions to “ EISSA HANNA M.D.” Practice Location

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