Provider Demographics
NPI:1255960951
Name:HANZLICEK, ABBY (MD)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:HANZLICEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 E PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7408
Mailing Address - Country:US
Mailing Address - Phone:785-825-7251
Mailing Address - Fax:
Practice Address - Street 1:651 E PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7408
Practice Address - Country:US
Practice Address - Phone:785-825-7251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE34473207Q00000X
KS04-10180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine