Healthcare Provider Details

I. General information

NPI: 1063726446
Provider Name (Legal Business Name): GREGORY ALAN TOCKS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 N POINTE BLVD
LANCASTER PA
17601
US

IV. Provider business mailing address

170 N POINTE BLVD STE 200
LANCASTER PA
17601-4132
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-4871
  • Fax: 717-391-2494
Mailing address:
  • Phone: 717-299-4871
  • Fax: 717-391-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116027757
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS018102
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number(0116027757)
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberOS018102
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: