Healthcare Provider Details

I. General information

NPI: 1912071291
Provider Name (Legal Business Name): WILLIAM M BOCK MDPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 WEST GARDEN STREET SUITE 206
AUBURN NY
13021
US

IV. Provider business mailing address

37 WEST GARDEN STREET SUITE 206
AUBURN NY
13021
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-6000
  • Fax: 315-253-4056
Mailing address:
  • Phone: 315-252-6000
  • Fax: 315-253-4056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM M BOCK
Title or Position: PRESIDENT
Credential: MD
Phone: 315-252-6000