Provider Demographics
NPI:1306163100
Name:JAMES E. HANLON MD, PLC
Entity type:Organization
Organization Name:JAMES E. HANLON MD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-375-6079
Mailing Address - Street 1:8145 VALLEYWOOD LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5296
Mailing Address - Country:US
Mailing Address - Phone:269-324-9162
Mailing Address - Fax:269-375-6078
Practice Address - Street 1:8145 VALLEYWOOD LN
Practice Address - Street 2:SUITE B
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5296
Practice Address - Country:US
Practice Address - Phone:269-324-9162
Practice Address - Fax:269-375-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty