Mark G Hanly, MBCHB, FRCPATHLOND | |
203 Indigo Dr, Brunswick, GA 31525-6865 | |
(912) 261-2669 | |
(912) 261-0561 |
Full Name | Mark G Hanly |
---|---|
Gender | Male |
Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
Location | 203 Indigo Dr, Brunswick, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619951258 | NPI | - | NPPES |
000638206B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 035181 (Georgia) | Primary |
Entity Name | Southeastern Pathology Associates Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821104704 PECOS PAC ID: 5890781371 Enrollment ID: O20040421000744 |
Mailing Address | Practice Location Address |
---|---|
Mark G Hanly, MBCHB, FRCPATHLOND Po Box 30309, Charleston, SC 29417-0309 Ph: (843) 554-9300 | Mark G Hanly, MBCHB, FRCPATHLOND 203 Indigo Dr, Brunswick, GA 31525-6865 Ph: (912) 261-2669 |
Dr. Yumi Angerica Kojima, D.O. Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 Fax: 912-261-0561 | |
Ningxing Chen, D.O. Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 | |
Rena Burlingame Rengo, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 | |
Shyamala Yennam, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 Fax: 912-261-0561 | |
Janet O. Hon, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3011 Hampton Ave, Sepa, Brunswick, GA 31520 Phone: 912-261-2669 Fax: 912-261-0561 | |
Carolyn Kinzer-bezanson Wall, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Drive, Southeastern Pathology Associates, Pc, Brunswick, GA 31525 Phone: 912-279-1900 Fax: 912-261-0753 | |
Rose P Draviam, M. D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3011 Hampton Ave, Brunswick, GA 31520 Phone: 912-261-2669 Fax: 912-261-0561 |