Provider Demographics
NPI:1063465839
Name:HANNAH, HAMNER (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMNER
Middle Name:
Last Name:HANNAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-906-0833
Mailing Address - Fax:913-906-0829
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-906-0833
Practice Address - Fax:913-906-0829
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15455174400000X
KS0415455208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100002240BMedicaid
KS100002240 FMedicaid
MO201059755Medicaid
KS10002240EMedicaid
KS100002240CMedicaid
MO201059748Medicaid
C52249Medicare UPIN
KS100002240 FMedicaid
MOMA1206002Medicare PIN
KS100002240BMedicaid
MO201059748Medicaid
KSP00457246Medicare PIN
MOP00641414Medicare PIN