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Organization
HANCOCK PHYSICIAN NETWORK, LLC
Active
Organization
HANCOCK PHYSICIAN NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MUCKERHEIDE (CONTROLLER)
(317) 468-6236
Entity
Organization
Contact information
Practice address
156 W MUSKEGON DR, GREENFIELD, IN 46140-3069
(317) 468-6260
(317) 468-6267
Mailing address
PO BOX 129, GREENFIELD, IN 46140-0129
(317) 468-6270
(317) 468-6268
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
70000074A
IN
163W00000X
Registered Nurse
28075482A
IN
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NULL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
01061823A
IN
208600000X
Surgery Physician
01062448A
IN
208M00000X
Hospitalist Physician
01052168A
IN
208M00000X
Hospitalist Physician
01064501A
IN
Other
Enumeration date
07/04/2006
Last updated
03/07/2023
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