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NPI Code Detail

MEDICARE: PATRICK HANKS MD

MEDICARE: PATRICK HANKS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician208204MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114911906
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK HANKS MD
Provider Business Mailing Address
First Line : 7595 ANAGRAM DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7399
Country : US
Telephone Number : 612-573-2200
Fax Number : 612-573-2274
Provider Business Practice Location Address
First Line : 295 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2134
Country : US
Telephone Number : 978-937-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 05/15/2023

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