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General NPI Number Information
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NPI Number | 1639505951
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Entity Type | Individual
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Provider Name | MARK RICHARD HANNAY MD
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Gender | Male
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1000 TOWNE CENTER BLVD BLDG 1200
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City | POOLER
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State | GA
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Zip | 31322-4129
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Country | US
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Telephone | 706-266-2411
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Fax |
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Provider Business Mailing Address
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Address Line | 1339 E 53RD ST
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City | SAVANNAH
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State | GA
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Zip | 31404-4605
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Country | US
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Telephone | 706-266-2411
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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 | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 0101263782
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 104494
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License Number State | GA
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