# HANCOCK PHYSICIAN NETWORK, LLC

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

## Provider details

- **NPI number:** 1609806470
- **Authorized official:** BRIAN MUCKERHEIDE (CONTROLLER)
- **Authorized official phone:** (317) 468-6236

## Contact information

- **Practice address:** 156 W MUSKEGON DR, GREENFIELD, IN 46140-3069
- **Practice address phone:** (317) 468-6260
- **Practice address fax:** (317) 468-6267
- **Mailing address:** PO BOX 129, GREENFIELD, IN 46140-0129
- **Mailing address phone:** (317) 468-6270
- **Mailing address fax:** (317) 468-6268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | 70000074A | IN | — |
| 163W00000X | Registered Nurse | 28075482A | IN | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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