Provider Demographics
NPI:1285824805
Name:PAUL D HANKENSON DO PC
Entity Type:Organization
Organization Name:PAUL D HANKENSON DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HANKENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-663-3344
Mailing Address - Street 1:1501 KYLE STREET
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827
Mailing Address - Country:US
Mailing Address - Phone:517-663-3344
Mailing Address - Fax:517-663-1703
Practice Address - Street 1:1501 KYLE STREET
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827
Practice Address - Country:US
Practice Address - Phone:517-663-3344
Practice Address - Fax:517-663-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty