Healthcare Provider Details

I. General information

NPI: 1326245432
Provider Name (Legal Business Name): HANCOCK MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 DRINKWATER BLVD
BAY SAINT LOUIS MS
39520-1658
US

IV. Provider business mailing address

149 DRINKWATER BLVD
BAY SAINT LOUIS MS
39520-1658
US

V. Phone/Fax

Practice location:
  • Phone: 228-467-8787
  • Fax: 228-467-8799
Mailing address:
  • Phone: 228-467-8787
  • Fax: 228-467-8799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11214
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11214
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number11214
License Number StateMS

VIII. Authorized Official

Name: MR. THOMAS P RAMSEY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 228-467-8787