Provider Demographics
NPI:1700405826
Name:HANCOCK, CHAD STEPHEN (PA-C)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:STEPHEN
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 E PLUM CREEK PKWY APT 202
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-4109
Mailing Address - Country:US
Mailing Address - Phone:303-919-7049
Mailing Address - Fax:
Practice Address - Street 1:1444 S POTOMAC ST STE 300
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4510
Practice Address - Country:US
Practice Address - Phone:303-750-0822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006262363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant