Healthcare Provider Details

I. General information

NPI: 1619081395
Provider Name (Legal Business Name): ANN MARIE HANON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 WEST 40 HWY
BLUE SPRINGS MO
64015-1133
US

IV. Provider business mailing address

256 SW WINTERPARK CIR
LEES SUMMIT MO
64081-4013
US

V. Phone/Fax

Practice location:
  • Phone: 816-224-8660
  • Fax: 816-220-9005
Mailing address:
  • Phone: 816-224-8660
  • Fax: 816-220-9005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000773
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: