Provider Demographics
NPI:1518975408
Name:HANCOCK, ROBERT CHRISTOPHER (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 E EMERALD AVE
Mailing Address - Street 2:SUITE 706
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917
Mailing Address - Country:US
Mailing Address - Phone:865-523-5655
Mailing Address - Fax:865-523-4882
Practice Address - Street 1:939 E EMERALD AVE
Practice Address - Street 2:SUITE 706
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917
Practice Address - Country:US
Practice Address - Phone:865-523-5655
Practice Address - Fax:865-523-4882
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000509213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66640Medicare UPIN
U66640Medicare UPIN
3714132Medicare ID - Type Unspecified