MEDICARE: DR. KRIS ALAN HANCHETT 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	207Q00000X	Family Medicine Physician	MD-10334	HI

General Provider Information

NPI Number	:	1851532923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRIS ALAN HANCHETT MD

Provider Business Mailing Address
First Line	:	1101 PUEBLO HILLS AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-6151
Country	:	US
Telephone Number	:	702-210-4205
Fax Number	:	702-633-6484

Provider Business Practice Location Address
First Line	:	1101 PUEBLO HILLS AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-6151
Country	:	US
Telephone Number	:	702-210-4205
Fax Number	:	702-633-6484

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

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	03/18/2009

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