Provider Demographics
NPI:1619014925
Name:HANLEY, KEVIN FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:FRANCIS
Last Name:HANLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3462 GODSPEED RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-1303
Mailing Address - Country:US
Mailing Address - Phone:410-721-5811
Mailing Address - Fax:410-721-5822
Practice Address - Street 1:1298 CRONSON BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2036
Practice Address - Country:US
Practice Address - Phone:410-721-5811
Practice Address - Fax:410-721-5822
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0032513207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery