Healthcare Provider Details

I. General information

NPI: 1003546508
Provider Name (Legal Business Name): GRACE SCHOCK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 ARKANSAS ST STE 300
LAWRENCE KS
66044-1394
US

IV. Provider business mailing address

325 MAINE STREET MSO LIBRARY
LAWRENCE KS
66044
US

V. Phone/Fax

Practice location:
  • Phone: 785-505-4950
  • Fax: 785-505-5240
Mailing address:
  • Phone: 785-505-2988
  • Fax: 785-505-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number05-54070
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: