MEDICARE: PAIGE DENISE MOCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1194612747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE DENISE MOCK

Provider Business Mailing Address
First Line	:	645 PRESTON TRAILS DR
Second Line	:
City	:	PICKERINGTON
State	:	OH
Zip	:	43147-2111
Country	:	US
Telephone Number	:	614-290-9586
Fax Number	:

Provider Business Practice Location Address
First Line	:	2741 S HAMILTON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4904
Country	:	US
Telephone Number	:	614-547-4493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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Directions to “ PAIGE DENISE MOCK ” Practice Location

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