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General NPI Number Information
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NPI Number | 1407922867
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Entity Type | Individual
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Provider Name | SCOTT JOSEPH HANEGAN DPM
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 1600 22ND AVE
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City | MERIDIAN
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State | MS
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Zip | 39301-3223
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Country | US
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Telephone | 601-483-5322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749215
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City | ATLANTA
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State | GA
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Zip | 30374-9215
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Country | US
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Telephone | 901-226-3186
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Fax |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 80165
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 80165
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License Number State | MS
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