Hancock, Jeffrey D

Hancock, Jeffrey D is an sole proprietor health care provider with primary practice located at 380 Walker Dr , Rexburg ID 83440-1657. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Hancock, Jeffrey D can be contacted via phone (208) 356-9559.

Contact Information

Primary practice address
380 Walker Dr Rexburg ID 83440-1657
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 5755112-1205 Utah

Profile Details

NPI number 1265637573
LBN Legal business name Hancock, Jeffrey D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2007
Last updated Nov 27th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265637573 NPPES
Idaho Other 000010163793 BLUE SHIELD
Idaho Other 8J950 BLUE SHIELD
Idaho MEDICAID 807823000 BLUE SHIELD

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