Hancock, Jack Haynes

Hancock, Jack Haynes is an individual health care provider with primary practice located at 10 Enterprise Blvd Suite 209, Greenville SC 29615-6301. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Hancock, Jack Haynes can be contacted via phone (864) 234-8811.

Contact Information

Primary practice address
10 Enterprise Blvd Suite 209 Greenville SC 29615-6301
Fax: (864) 234-8844
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 1588 South Carolina

Profile Details

NPI number 1013902980
LBN Legal business name Hancock, Jack Haynes
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Jul 8th, 2007 - about 18 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 1013902980 NPPES
South Carolina MEDICAID Z15889

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