Healthcare Provider Details

I. General information

NPI: 1548782907
Provider Name (Legal Business Name): MICHAEL WAYNE HANKINS JR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E STATE ST
ALBION PA
16401-1306
US

IV. Provider business mailing address

1 LECOM PL
ERIE PA
16505-2571
US

V. Phone/Fax

Practice location:
  • Phone: 814-756-3434
  • Fax: 814-756-4725
Mailing address:
  • Phone: 814-864-4031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006820
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: