Individual
RYAN HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
810 S 6TH ST, MONTICELLO, IN 47960-8201
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01080491A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001187706
ANTHEM PROVIDER PIN
IN
05
—
300018903
—
IN
Enumeration date
04/21/2015
Last updated
02/02/2021
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