Healthcare Provider Details

I. General information

NPI: 1366623878
Provider Name (Legal Business Name): MR. GREGORY ALLEN HANKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

IV. Provider business mailing address

923 PRINCESS DR
WEAVER AL
36277-4542
US

V. Phone/Fax

Practice location:
  • Phone: 404-728-7626
  • Fax: 404-728-7795
Mailing address:
  • Phone: 256-820-9398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: