Healthcare Provider Details

I. General information

NPI: 1720019482
Provider Name (Legal Business Name): ALAN PATRICK BOCKO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 E FRANKLIN ST SUITE 104
CHAPEL HILL NC
27514-2825
US

IV. Provider business mailing address

1506 E FRANKLIN ST SUITE 104
CHAPEL HILL NC
27514-2825
US

V. Phone/Fax

Practice location:
  • Phone: 919-960-8858
  • Fax: 919-960-2882
Mailing address:
  • Phone: 919-960-8858
  • Fax: 919-960-2882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number410
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number410
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: