| Dr Kathleen Lee Hannan, MD | |
| 915 Gordon Ave, Thomasville, GA 31792-6614 | |
| (229) 228-2000 | |
| Not Available | 
| Full Name | Dr Kathleen Lee Hannan | 
|---|---|
| Gender | Female | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 915 Gordon Ave, Thomasville, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1104870724 | NPI | - | NPPES | 
| 000810851Y | Medicaid | GA | |
| 252662000 | Medicaid | FL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 056572 (Georgia) | Primary | 
| Entity Name | Steward Medical Group Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356654495 PECOS PAC ID: 2860688728 Enrollment ID: O20170602001215 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Kathleen Lee Hannan, MD 920 Us Highway 84 W, Thomasville, GA 31792-0510 Ph: (229) 228-8857 | Dr Kathleen Lee Hannan, MD 915 Gordon Ave, Thomasville, GA 31792-6614 Ph: (229) 228-2000 | 
| Kelley Stafford Helquist, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 714 N Dawson St, Thomasville, GA 31792 Phone: 904-252-7761 | |
| Jerry Steven Johnson, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 116 Mimosa Dr, Thomasville, GA 31792 Phone: 229-228-2982 Fax: 229-551-8784 | |
| Dr. Eduardo Jose Stincer, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 915 Gordon Ave, Thomasville, GA 31792 Phone: 229-228-2000 | |
| Dr. Sharif Darwish, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 915 Gordon Ave, Thomasville, GA 31792 Phone: 229-228-2000 | |
| Dr. David Andrew Saunders, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 116 Mimosa Dr, Thomasville, GA 31792 Phone: 229-228-2982 Fax: 229-551-8784 | |
| Dr. Cary Carter Newman, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 915 Gordon Ave, Thomasville, GA 31792 Phone: 229-228-2000 |