Healthcare Provider Details

I. General information

NPI: 1619941994
Provider Name (Legal Business Name): STEVEN RICHARD HANLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 STEVENS CREEK RD
AUGUSTA GA
30907-9251
US

IV. Provider business mailing address

134 RENDOVA CIR
CORONADO CA
92118-3114
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-6957
  • Fax: 706-722-1999
Mailing address:
  • Phone: 619-228-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101234616
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA102588
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA102588
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number78517
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: