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General NPI Number Information
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NPI Number | 1740308121
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Entity Type | Individual
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Provider Name | RAYMOND A MOCK ACNP
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 833 PRINCETON AVE SW STE 200A
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City | BIRMINGHAM
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State | AL
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Zip | 35211
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Country | US
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Telephone | 205-786-2776
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Fax | 205-786-6227
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Provider Business Mailing Address
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Address Line | 1130 22ND ST S STE 1000
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City | BIRMINGHAM
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State | AL
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Zip | 35205-2881
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Country | US
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Telephone | 469-893-2065
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Fax | 469-893-3065
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 203699
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-083338
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R865463
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License Number State | MS
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