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General NPI Number Information
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NPI Number | 1033371513
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Entity Type | Individual
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Provider Name | FREDERICK C ROCK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 9825 GILES RD SUITE F
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City | LA VISTA
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State | NE
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Zip | 68128-2927
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Country | US
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Telephone | 402-339-2283
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Fax |
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Provider Business Mailing Address
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Address Line | 5033 CASTELAR ST
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City | OMAHA
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State | NE
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Zip | 68106-3146
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Country | US
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Telephone | 402-408-2102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 26260
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License Number State | NE
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