# HANCOCK FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184732448
- **Authorized official:** DR. RONALD KELLUM MD (MD OWNER)
- **Authorized official phone:** (228) 586-9229

## Contact information

- **Practice address:** 5400 INDIAN HILL BLVD, DIAMONDHEAD, MS 39525-3334
- **Practice address phone:** (228) 586-9229
- **Practice address fax:** (228) 586-9230
- **Mailing address:** 5400 INDIAN HILL BLVD, DIAMONDHEAD, MS 39525-3334
- **Mailing address phone:** (228) 586-9229
- **Mailing address fax:** (228) 586-9230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/28/2006
- **Last updated:** 11/26/2007