Provider Demographics
NPI:1811043771
Name:HANCOCK, SCOTT ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
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 1:1010A E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-2308
Mailing Address - Country:US
Mailing Address - Phone:601-656-8710
Mailing Address - Fax:601-389-0760
Practice Address - Street 1:1010A E MAIN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-2308
Practice Address - Country:US
Practice Address - Phone:601-656-8710
Practice Address - Fax:601-389-0760
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSU70661Medicare UPIN
MS350000220Medicare ID - Type Unspecified