Healthcare Provider Details

I. General information

NPI: 1184086811
Provider Name (Legal Business Name): HANNA HUSSEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNA LEE

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 01/12/2022
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST S # JT920
BIRMINGHAM AL
35249-6810
US

IV. Provider business mailing address

619 19TH ST S # JT920
BIRMINGHAM AL
35249-6810
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-6525
  • Fax:
Mailing address:
  • Phone: 205-934-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number38891
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: