Provider Demographics
NPI:1033274964
Name:HANAN, STANLEY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:SCOTT
Last Name:HANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2904 WAUHILAH DR
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-8017
Mailing Address - Country:US
Mailing Address - Phone:918-492-2554
Mailing Address - Fax:918-494-9870
Practice Address - Street 1:7010 S YALE AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5713
Practice Address - Country:US
Practice Address - Phone:918-492-2554
Practice Address - Fax:918-494-9870
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK11542208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD34750Medicare UPIN