Healthcare Provider Details

I. General information

NPI: 1609287580
Provider Name (Legal Business Name): ELLEN M HANCOX M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN M WALLACE

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 MYRTLE STREET SUITE G30
ERIE PA
16502-4602
US

IV. Provider business mailing address

2315 MYRTLE STREET SUITE G30
ERIE PA
16502-4602
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-5514
  • Fax: 814-452-5504
Mailing address:
  • Phone: 814-452-5514
  • Fax: 814-452-5504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.155448
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD465034
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: