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1720067994

NPI Code Detail

MEDICARE: DR. JOHN C HANCOCK MD

MEDICARE: DR. JOHN C HANCOCK MD

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	207ZH0000X	Hematology (Pathology) Physician	12120	MS
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	12120	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01435504	OTHER	MS	RAILROAD MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1720067994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN C HANCOCK MD

Provider Business Mailing Address
First Line	:	969 LAKELAND DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4606
Country	:	US
Telephone Number	:	601-200-6762
Fax Number	:

Provider Business Practice Location Address
First Line	:	969 LAKELAND DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4606
Country	:	US
Telephone Number	:	607-200-6762
Fax Number	:

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	08/02/2021

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Directions to “ DR. JOHN C HANCOCK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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