Provider Demographics
NPI:1992120653
Name:DR JAMES HANUS MEDICAL CLINIC PC
Entity type:Organization
Organization Name:DR JAMES HANUS MEDICAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:HANUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:260-420-7283
Mailing Address - Street 1:216 S. STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH WHITLEY
Mailing Address - State:IN
Mailing Address - Zip Code:46787-1300
Mailing Address - Country:US
Mailing Address - Phone:260-272-4484
Mailing Address - Fax:260-272-4485
Practice Address - Street 1:216 S. STATE STREET
Practice Address - Street 2:
Practice Address - City:SOUTH WHITLEY
Practice Address - State:IN
Practice Address - Zip Code:46787-1300
Practice Address - Country:US
Practice Address - Phone:260-272-4484
Practice Address - Fax:260-272-4485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000545A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty