MEDICARE: DR. JAMES ASHLEY HANCOCK D.D.S.

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	1223G0001X	General Practice Dentistry	4602	OK

General Provider Information

NPI Number	:	1932190964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ASHLEY HANCOCK D.D.S.

Provider Business Mailing Address
First Line	:	6010 N VILLA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7158
Country	:	US
Telephone Number	:	405-843-5537
Fax Number	:

Provider Business Practice Location Address
First Line	:	6010 N VILLA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7158
Country	:	US
Telephone Number	:	405-843-5537
Fax Number	:

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	04/22/2008

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