MEDICARE: DR. ANIS HANNA 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
1	207RG0100X	Gastroenterology Physician	32219	AZ
2	174400000X	Specialist	32219	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1639136245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANIS HANNA MD

Provider Business Mailing Address
First Line	:	3040 N SWAN RD, STE B
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1206
Country	:	US
Telephone Number	:	520-327-3454
Fax Number	:	520-327-3431

Provider Business Practice Location Address
First Line	:	3040 N SWAN RD, STE B
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1206
Country	:	US
Telephone Number	:	520-327-3454
Fax Number	:	520-327-3431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	03/13/2024

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