Provider Demographics
NPI:1578533055
Name:HANOR, STEVEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:HANOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 W STONE DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3365
Mailing Address - Country:US
Mailing Address - Phone:423-408-7220
Mailing Address - Fax:423-408-7405
Practice Address - Street 1:1 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 200 EAST
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7430
Practice Address - Country:US
Practice Address - Phone:423-844-5100
Practice Address - Fax:423-844-5109
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN14878207R00000X
VA0101036348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3001158Medicaid
VAVVD202BMedicare PIN
TN110120206Medicare PIN
TN3001158Medicaid
TN103I112814Medicare PIN
TN3001153Medicare PIN