Provider Demographics
NPI:1356458970
Name:HANON, DANIEL RAYMOND (DPM)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RAYMOND
Last Name:HANON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SW WINTERPARK CIR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-4013
Mailing Address - Country:US
Mailing Address - Phone:816-224-8660
Mailing Address - Fax:816-220-9005
Practice Address - Street 1:1136 WEST 40 HWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-1133
Practice Address - Country:US
Practice Address - Phone:816-224-8660
Practice Address - Fax:816-220-9005
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000774213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO304667405Medicaid
4349950001OtherDMERC
480033833OtherRR MCR
MOU75663Medicare UPIN
MO304667405Medicaid
4349950001OtherDMERC
4349950001Medicare NSC