Provider Demographics
NPI:1801862917
Name:HANNAY, RICHARD SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:SCOTT
Last Name:HANNAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1038
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1038
Mailing Address - Country:US
Mailing Address - Phone:706-660-6148
Mailing Address - Fax:706-660-2843
Practice Address - Street 1:920 18TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1524
Practice Address - Country:US
Practice Address - Phone:706-649-6600
Practice Address - Fax:706-649-6614
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050176208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52596568-001OtherBCBS
GA000911908COtherMEDICAID-OFFICE
AL601-11865OtherBCBS
GA000911908DOtherMEDICAID-MMC
AL154403OtherMEDICAID-OFFICE
GA000911908COtherMEDICAID-OFFICE