MEDICARE: DR. PATRICK HANFORD DO

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	207Q00000X	Family Medicine Physician	G6723	TX
2	207P00000X	Emergency Medicine Physician	G6723	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669444592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK HANFORD DO

Provider Business Mailing Address
First Line	:	4617 91ST ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-5035
Country	:	US
Telephone Number	:	806-794-5077
Fax Number	:	806-794-5077

Provider Business Practice Location Address
First Line	:	4617 91ST ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-5035
Country	:	US
Telephone Number	:	806-794-5077
Fax Number	:	806-794-5077

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

Provider Enumeration Date	:	02/04/2006
Last Update Date	:	02/04/2014

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