Provider Demographics
NPI:1376624627
Name:HANCOCK, WILLIAM G IV (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:HANCOCK
Suffix:IV
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-0305
Mailing Address - Country:US
Mailing Address - Phone:734-429-9459
Mailing Address - Fax:734-429-5421
Practice Address - Street 1:7330 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-9197
Practice Address - Country:US
Practice Address - Phone:734-429-9459
Practice Address - Fax:734-429-5421
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIWH002538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95OH150190OtherBCBS
MI133634Medicare UPIN
MIOH15019Medicare ID - Type UnspecifiedMEDICARE