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General NPI Number Information
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NPI Number | 1740623990
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Entity Type | Organization
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Legal Business Name | HANCOCK MEDICAL HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 4540B SHEPHERD SQ
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City | DIAMONDHEAD
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State | MS
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Zip | 39525-3325
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Country | US
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Telephone | 228-395-1234
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Fax | 228-395-1235
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Provider Business Mailing Address
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Address Line | 149 DRINKWATER RD ATTN: REBECCA THERIOT
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City | BAY ST LOUIS
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State | MS
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Zip | 39520-1658
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Country | US
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Telephone | 228-467-8676
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Fax | 228-467-8674
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Authorized Official
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Title or Position | DIRECTOR OPERATIONS
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Name | MR. GUY KEN SMITH
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Credential | MBA
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Telephone | 985-898-7091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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