Provider Demographics
NPI:1386937837
Name:STANLEY L HANNAH M.D.
Entity type:Organization
Organization Name:STANLEY L HANNAH M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-761-1028
Mailing Address - Street 1:5 MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILLS VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80113-4820
Mailing Address - Country:US
Mailing Address - Phone:303-761-1028
Mailing Address - Fax:303-761-1028
Practice Address - Street 1:5 MARTIN LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILLS VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80113
Practice Address - Country:US
Practice Address - Phone:303-761-1028
Practice Address - Fax:303-761-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14537261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty