Casey Hanna MD Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21947 Issued in OK

Legal business name

CASEY HANNA MD PROFESSIONAL CORPORATION

Practice address

1202 W Cherokee St Ste E
Wagoner, OK 74467-4629

Phone

(918) 485-5188

Fax

(915) 485-5402

NPI assigned

Dec 11, 2007

Last updated

Jul 22, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bryan Casey Hanna, MD

Title

Owner

Phone

(918) 485-5188

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1003099276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 894",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744770894",
            "telephone_number": "918-485-5188",
            "fax_number": "918-485-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W CHEROKEE ST STE E",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674629",
            "telephone_number": "918-485-5188",
            "fax_number": "915-485-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY HANNA MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "CASEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-485-5188",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "21947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Wagoner, OK
• Providers in Wagoner, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.