Basic Information
Provider Information
NPI: 1730131814
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANLON
FirstName: PHILIP
MiddleName: R.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1034 23RD ST S
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352052481
CountryCode: US
TelephoneNumber: 2053223332
FaxNumber: 2053221305
Practice Location
Address1: 2890 DAUPHIN ST
Address2:  
City: MOBILE
State: AL
PostalCode: 366062457
CountryCode: US
TelephoneNumber: 2514732020
FaxNumber: 2053221305
Other Information
ProviderEnumerationDate: 05/16/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X00011246ALY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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