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Organization

WALTER HANCOCK DPM PC

Active
Parent organization
WALTER HANCOCK DPM PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
WALTER HANCOCK DPM PC
Authorized official
MR. WALTER HANCOCK DPM (DPM)
(812) 477-1821
Entity
Organization

Contact information

Practice address
2042 LINCOLN AVE, EVANSVILLE, IN 47714-1561
(812) 477-1821
(812) 475-0327
Mailing address
2042 LINCOLN AVE, EVANSVILLE, IN 47714-1561
(812) 477-1821
(812) 475-0327

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000330
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000042449
ANTHEM BLUE SHEILD
IN
01
000000108408
ANTHEM BLUE SHEILD
IN
01
0243760002
MEDICARE DME
IN
05
100110420 A & B
IN
01
480068075 A
PALMETTO MEDICARE
IN
Enumeration date
01/22/2007
Last updated
06/17/2011
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