MEDICARE: HANCOCK MEDICAL CENTER

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	11214	MS
2	207R00000X	Internal Medicine Physician	11214	MS
3	208000000X	Pediatrics Physician	11214	MS
4	208600000X	Surgery Physician	11214	MS
5	213E00000X	Podiatrist	11214	MS
6	367500000X	Certified Registered Nurse Anesthetist	11214	MS
7	207L00000X	Anesthesiology Physician	11214	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19166A	OTHER	MS	B-CROSS CRNA PRO FEE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730118068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANCOCK MEDICAL CENTER

Provider Business Mailing Address
First Line	:	149 DRINKWATER RD
Second Line	:
City	:	BAY SAINT LOUIS
State	:	MS
Zip	:	39520-1658
Country	:	US
Telephone Number	:	228-467-8787
Fax Number	:	228-467-8799

Provider Business Practice Location Address
First Line	:	149 DRINKWATER BLVD
Second Line	:
City	:	BAY SAINT LOUIS
State	:	MS
Zip	:	39520-1658
Country	:	US
Telephone Number	:	228-467-8787
Fax Number	:	228-467-8799

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. THOMAS P RAMSEY
Credential	:
Telephone Number	:	228-467-8787

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	03/02/2015

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149 DRINKWATER BLVD
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Directions to “HANCOCK MEDICAL CENTER ” Practice Location

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