Provider Demographics
NPI:1558493247
Name:HANCOCK, MICHAEL JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:HANCOCK
Suffix:
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 1:6211 NICKEL RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9114
Mailing Address - Country:US
Mailing Address - Phone:513-519-7021
Mailing Address - Fax:
Practice Address - Street 1:8251 PINE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2191
Practice Address - Country:US
Practice Address - Phone:513-241-4066
Practice Address - Fax:513-241-4066
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2177111N00000X
AL2340111N00000X
NC4272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2276460Medicaid
OHU56512Medicare UPIN
OH2276460Medicaid