Provider Demographics
NPI:1972827004
Name:HANCOCK MEDICAL CENTER
Entity Type:Organization
Organization Name:HANCOCK MEDICAL CENTER
Other - Org Name:HANCOCK MEDICAL NURSE PRACTITIONERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-467-8787
Mailing Address - Street 1:149 DRINKWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-1658
Mailing Address - Country:US
Mailing Address - Phone:228-467-8787
Mailing Address - Fax:228-467-8799
Practice Address - Street 1:149 DRINKWATER BLVD
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-1658
Practice Address - Country:US
Practice Address - Phone:228-467-8787
Practice Address - Fax:228-467-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS250162Medicare PIN