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NPI Code Detail

MEDICARE: HANCOCK MEDICAL HEALTH SERVICES, INC.

MEDICARE: HANCOCK MEDICAL HEALTH SERVICES, INC.
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
1208600000XSurgery Physician11217MS
2261QM1300XMulti-Specialty Clinic/CenterMS

General Provider Information

NPI Number : 1366751604
Entity Type Code : Organization
Provider Name (Legal Business Name) : HANCOCK MEDICAL HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 2790
Second Line :
City : BAY ST LOUIS
State : MS
Zip : 39521-2790
Country : US
Telephone Number : 228-467-8700
Fax Number : 228-467-8799
Provider Business Practice Location Address
First Line : 100 DRINKWATER RD
Second Line :
City : BAY ST LOUIS
State : MS
Zip : 39520-1614
Country : US
Telephone Number : 228-463-8939
Fax Number : 228-463-8938
Authorized Official
Title or Position : DIRECTOR OPERATIONS
Name : MR. GUY KEN SMITH
Credential : MBA
Telephone Number : 985-898-7091
Provider Enumeration Date : 10/05/2010
Last Update Date : 05/02/2014

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Directions to “HANCOCK MEDICAL HEALTH SERVICES, INC. ” Practice Location

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