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General NPI Number Information
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NPI Number | 1255827358
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Entity Type | Organization
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Legal Business Name | HANNA ANKLE & FOOT
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 3901 DUTCHMANS LN STE 104
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City | LOUISVILLE
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State | KY
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Zip | 40207-4726
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Country | US
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Telephone | 502-365-1899
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 DUTCHMANS LN STE 104
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City | LOUISVILLE
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State | KY
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Zip | 40207-4726
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Country | US
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Telephone | 502-365-1899
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY D HANNA
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Credential | DPM
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Telephone | 502-365-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00382
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License Number State | KY
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