Healthcare Provider Details

I. General information

NPI: 1437854205
Provider Name (Legal Business Name): ERIC JAMES HANCOCK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W LORAIN ST STE 100
OBERLIN OH
44074-1087
US

IV. Provider business mailing address

224 W LORAIN ST STE 100
OBERLIN OH
44074-1087
US

V. Phone/Fax

Practice location:
  • Phone: 440-930-6015
  • Fax: 440-960-6094
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.004249
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: