MEDICARE: JOHN EDWARD HANKS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	A163113	CA
2	207Y00000X	Otolaryngology Physician	A163113	CA

General Provider Information

NPI Number	:	1679986772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN EDWARD HANKS MD

Provider Business Mailing Address
First Line	:	150 S HUNTINGTON AVE
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-4817
Country	:	US
Telephone Number	:	857-364-3130
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 S HUNTINGTON AVE
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-4817
Country	:	US
Telephone Number	:	857-364-3130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	03/10/2026

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Directions to “ JOHN EDWARD HANKS MD” Practice Location

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