MEDICARE: DAN L HANCOCK M. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	036.177363	IL
2	207L00000X	Anesthesiology Physician	R1F57	MO
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	R1F57	MO

General Provider Information

NPI Number	:	1285621920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN L HANCOCK M. D.

Provider Business Mailing Address
First Line	:	3604 SADDLE RIDGE DR
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-2332
Country	:	US
Telephone Number	:	816-698-8900
Fax Number	:	816-698-8905

Provider Business Practice Location Address
First Line	:	19550 E 39TH ST STE 110
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-2353
Country	:	US
Telephone Number	:	816-698-8900
Fax Number	:	816-698-8905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	10/01/2025

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