Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 22486 | WV |
N | 207N00000X | Dermatologist | A90075 | CA |
N | 207N00000X | Dermatologist | MD430086 | PA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 22486 | WV |
N | 207ND0101X | MOHS-Micrographic Surgeon | MD430086 | PA |
N | 207NS0135X | Procedural Dermatology | 22486 | WV |
N | 207NS0135X | Procedural Dermatology | MD430086 | PA |
NPI | 1104804632 |
---|---|
Provider Name | Dr. John G. Hancox |
First Address | Clarksburg, WV 26301-2665 |
Second Address | Morgantown, WV 26508-8847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 23/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102138838 | (05) | PA |
3810006177 | (05) | WV |
I45478 | (02) | CA |
I45478 | (02) | WV |