Provider Demographics
NPI:1891782991
Name:HANCOCK EYE ASSOCIATES PC
Entity Type:Organization
Organization Name:HANCOCK EYE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VAN SCYOC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-462-6601
Mailing Address - Street 1:1451 JASON RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1039
Mailing Address - Country:US
Mailing Address - Phone:317-462-6601
Mailing Address - Fax:317-462-6625
Practice Address - Street 1:1451 JASON RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1039
Practice Address - Country:US
Practice Address - Phone:317-462-6601
Practice Address - Fax:317-462-6625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000175425OtherANTHEM
INM100046230Medicare PIN
IN3903600001Medicare NSC