Provider Demographics
NPI:1386610178
Name:HANKINSON, SCOTT BRIAN (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:BRIAN
Last Name:HANKINSON
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 1:2003 MEDICAL PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7992
Mailing Address - Country:US
Mailing Address - Phone:410-266-7755
Mailing Address - Fax:410-266-1141
Practice Address - Street 1:2601 W ALAMEDA AVE STE 212
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4814
Practice Address - Country:US
Practice Address - Phone:818-847-6990
Practice Address - Fax:818-847-6938
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG141830207V00000X
FLME130623207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD56524OtherSTATE LICENSE
CAG141830OtherSTATE LICENSE
257SMedicare ID - Type Unspecified