Provider Demographics
NPI:1528386984
Name:HANNER, WILLIAM AARON (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:AARON
Last Name:HANNER
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 1:3336 E 32ND ST STE 250
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-4448
Mailing Address - Country:US
Mailing Address - Phone:919-600-0025
Mailing Address - Fax:918-600-0024
Practice Address - Street 1:3336 E 32ND ST STE 250
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-4448
Practice Address - Country:US
Practice Address - Phone:919-600-0025
Practice Address - Fax:918-600-0024
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5084208600000X, 207P00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200845040AMedicaid
OK200346250AMedicaid
OK1083750525OtherGROUP NPI
OK730768966OtherMEDICARE GROUP NUMBER