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NPI Code Detail

MEDICARE: DR. CHAN S HAN MD

MEDICARE: DR. CHAN S HAN 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
1174400000XSpecialist15718KS

General Provider Information

NPI Number : 1568468429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAN S HAN MD
Provider Business Mailing Address
First Line : 908 SIGGINS ST
Second Line :
City : COFFEYVILLE
State : KS
Zip : 67337-2921
Country : US
Telephone Number : 620-251-1560
Fax Number : 620-251-8144
Provider Business Practice Location Address
First Line : 908 SIGGINS ST
Second Line :
City : COFFEYVILLE
State : KS
Zip : 67337-2921
Country : US
Telephone Number : 620-251-1560
Fax Number : 620-251-8144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 07/08/2007

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