Provider Demographics
NPI:1720523236
Name:HANCOCK, JEFFREY LLOYD
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LLOYD
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 NW 4TH ST APT F
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-6927
Mailing Address - Country:US
Mailing Address - Phone:405-421-1862
Mailing Address - Fax:
Practice Address - Street 1:1729 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-2810
Practice Address - Country:US
Practice Address - Phone:405-415-8500
Practice Address - Fax:405-415-8497
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist