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General NPI Number Information
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NPI Number | 1023318227
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Entity Type | Individual
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Provider Name | HEATHER ANNE HANLON O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 11110 MALL CIR BOX 6140
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City | WALDORF
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State | MD
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Zip | 20603-4803
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Country | US
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Telephone | 301-705-8450
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Fax | 301-705-8448
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Provider Business Mailing Address
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Address Line | 11110 MALL CIR BOX 6140
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City | WALDORF
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State | MD
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Zip | 20603-4803
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Country | US
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Telephone | 301-705-8450
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Fax | 301-705-8448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4588
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2223
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License Number State | MD
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