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General NPI Number Information
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NPI Number | 1962709048
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Entity Type | Organization
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Legal Business Name | HANCOCK VEIN & SURGICAL CENTER PC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 603 PILOT HOUSE DR STE 240
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City | NEWPORT NEWS
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State | VA
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Zip | 23606
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Country | US
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Telephone | 757-873-0138
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Fax | 757-873-0246
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Provider Business Mailing Address
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Address Line | 119 JAMES LANDING RD
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2052
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Country | US
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Telephone | 910-612-5118
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Fax | 757-873-0246
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN MARIE HANCOCK
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Credential | MD
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Telephone | 910-612-5118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101242791
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License Number State | VA
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