Individual
DR. JOHN C HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(607) 200-6762
Mailing address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-6762
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
12120
MS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12120
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00113018
—
MS
05
—
1980986
—
LA
01
—
P01435504
RAILROAD MEDICARE PTAN
MS
Enumeration date
01/16/2006
Last updated
08/02/2021
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