Provider Demographics
NPI:1154413672
Name:HANNAH, ANN ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:ELIZABETH
Last Name:HANNAH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:401 N THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3468
Mailing Address - Country:US
Mailing Address - Phone:706-278-1388
Mailing Address - Fax:706-278-6480
Practice Address - Street 1:401 N THORNTON AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3468
Practice Address - Country:US
Practice Address - Phone:706-278-1388
Practice Address - Fax:706-278-6480
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA822152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU32326Medicare UPIN