Provider Demographics
NPI:1255317814
Name:HANUS, JAMES F (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:HANUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 S. STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH WHITLEY
Mailing Address - State:IN
Mailing Address - Zip Code:46787-1300
Mailing Address - Country:US
Mailing Address - Phone:260-272-4484
Mailing Address - Fax:260-272-4485
Practice Address - Street 1:216 S. STATE STREET
Practice Address - Street 2:
Practice Address - City:SOUTH WHITLEY
Practice Address - State:IN
Practice Address - Zip Code:46787-1300
Practice Address - Country:US
Practice Address - Phone:260-272-4484
Practice Address - Fax:260-272-4485
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000545A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00001076487 03OtherUNITED HEALTHCARE
IN3937240025OtherMEDICARE DMEPOS
IN100263030Medicaid
IN000000111793OtherANTHEM
IN1373OtherPHYSICIANS HEALTH PLAN
IN000000570542OtherANTHEM
4047116OtherAETNA
IN3937240019OtherMEDICARE DMEPOS
IN000000570542OtherANTHEM
IN069860HHHMedicare PIN
IN3937240025OtherMEDICARE DMEPOS
IN3937240019OtherMEDICARE DMEPOS
E35244Medicare UPIN
IN080130014Medicare PIN