Doctor Name: | MR. PHILLIP LEWIS HANSELL |
NPI Number: | 1326264151 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | MA001764L |
Business Practice Address: | 4607 Oakwood Ln Nazareth, PA - 180648535 |
Business Phone Number: | 6108374683 |
Business Fax Number: | 6108374975 |
Mailing Address: | 3515 W Union St, ALLENTOWN |
State: | PA |
Postal Code: | 181045948 |
Phone Number: | 6107400336 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA001764L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |