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General NPI Number Information
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NPI Number | 1588673990
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Entity Type | Individual
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Provider Name | SCOTT EDWARD HANNAH OD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1805 E WALNUT AVE
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City | DALTON
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State | GA
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Zip | 30721-4338
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Country | US
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Telephone | 706-278-1252
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Fax | 706-279-2062
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Provider Business Mailing Address
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Address Line | 2202 LOWER KINGS BRIDGE RD NE
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City | DALTON
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State | GA
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Zip | 30721-7051
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Country | US
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Telephone | 706-259-3640
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Fax | 706-279-2062
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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 | OPT000722
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License Number State | GA
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