Healthcare Provider Details

I. General information

NPI: 1578562856
Provider Name (Legal Business Name): RAYMOND PATRICK ROCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 PRINCETON-GLENDALE RD
WEST CHESTER OH
45069-0000
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-5479
Mailing address:
  • Phone: 513-246-7796
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35. 049367
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: