Healthcare Provider Details

I. General information

NPI: 1356391791
Provider Name (Legal Business Name): DAVID T ROCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 5TH AVE
COLUMBUS GA
31904-8915
US

IV. Provider business mailing address

9071 BONITA BEACH RD SE STE 1389
BONITA SPRINGS FL
34135-4213
US

V. Phone/Fax

Practice location:
  • Phone: 706-320-8660
  • Fax:
Mailing address:
  • Phone: 724-859-8783
  • Fax: 239-359-6480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME110898
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number47940
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: