Individual
STACEY HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6636 E BASELINE RD, MESA, AZ 85206-4430
(480) 912-6262
Mailing address
6636 E BASELINE RD, MESA, AZ 85206-4430
(480) 912-6262
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
009714
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2014
Last updated
02/24/2023
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