Provider Demographics
NPI:1992742936
Name:HANCOCK, JOHN PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PHILIP
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3201 HUXLEY DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3128
Mailing Address - Country:US
Mailing Address - Phone:706-774-7760
Mailing Address - Fax:706-774-7766
Practice Address - Street 1:1303 DANTIGNAC ST
Practice Address - Street 2:SUITE #1200
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2775
Practice Address - Country:US
Practice Address - Phone:706-774-7760
Practice Address - Fax:706-774-7766
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038506207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11BDPWWMedicare ID - Type Unspecified
GAF96894Medicare UPIN