Healthcare Provider Details

I. General information

NPI: 1992702047
Provider Name (Legal Business Name): HANKINS-CONRAD MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12370 PETALON TRACE
FISHERS IN
46037
US

IV. Provider business mailing address

12370 PETALON TRACE
FISHERS IN
46037
US

V. Phone/Fax

Practice location:
  • Phone: 800-513-6965
  • Fax: 800-513-6997
Mailing address:
  • Phone: 800-513-6965
  • Fax: 800-513-6997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateIN

VIII. Authorized Official

Name: MS. MARTHA J HANKINS
Title or Position: PRESIDENT
Credential:
Phone: 800-513-6965