Provider Demographics
NPI:1194725846
Name:HANCOCK, DAVID WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
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 1:4375 W HANCOCK RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-5532
Mailing Address - Country:US
Mailing Address - Phone:928-717-2324
Mailing Address - Fax:
Practice Address - Street 1:805 WHIPPLE ST
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1617
Practice Address - Country:US
Practice Address - Phone:928-445-5607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0937280OtherBC/BS ID#
AZ73819Medicare PIN
AZ73805Medicare PIN
AZ73804Medicare ID - Type UnspecifiedGROUP PROVIDER ID#
AZ73818Medicare ID - Type UnspecifiedGROUP PROVIDER ID #
AZAZ0937280OtherBC/BS ID#