Provider Demographics
NPI:1528317757
Name:HANCOCK, RONALD DAVID (HAS)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DAVID
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 N 9TH AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8280
Mailing Address - Country:US
Mailing Address - Phone:850-477-5935
Mailing Address - Fax:850-477-5936
Practice Address - Street 1:105 N 40TH AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6606
Practice Address - Country:US
Practice Address - Phone:601-264-2692
Practice Address - Fax:601-336-8127
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS 4874237700000X
AL2254237700000X
MSHA0625237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist