Provider Demographics
NPI:1285621920
Name:HANCOCK, DAN L (M D)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:L
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 SADDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2332
Mailing Address - Country:US
Mailing Address - Phone:816-698-8900
Mailing Address - Fax:816-698-8905
Practice Address - Street 1:19550 E 39TH ST STE 110
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2353
Practice Address - Country:US
Practice Address - Phone:816-698-8900
Practice Address - Fax:816-698-8905
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1F57207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO072295OtherFHP MEDICAID
20703099OtherBCBS OF KANSAS CITY
MO202472049Medicaid
A83442Medicare UPIN
MOL475694Medicare PIN
MO202472049Medicaid
KSL475694BMedicare PIN