Basic Information
| Provider Information | |||||||||
| NPI: | 1245318724 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOCK | ||||||||
| FirstName: | ERICH | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | PODIATRIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43160 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857333160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207223777 | ||||||||
| FaxNumber: | 5202966224 | ||||||||
| Practice Location | |||||||||
| Address1: | 7320 N LA CHOLLA BLVD | ||||||||
| Address2: | STE 154-214 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857412309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202191477 | ||||||||
| FaxNumber: | 5207971254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 11/15/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 138 | AZ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.