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NPI Code Detail

MEDICARE: DR. JOHN CHARLES ROCK MD

MEDICARE:  DR. JOHN CHARLES ROCK  MD
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
12085R0202XDiagnostic Radiology Physician01028676IN

Other Identifiers

General Provider Information

NPI Number : 1205807344
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN CHARLES ROCK MD
Provider Business Mailing Address
First Line : PO BOX 80070
Second Line :
City : FORT WAYNE
State : IN
Zip : 46898-0070
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Provider Business Practice Location Address
First Line : 6119 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-3072
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 06/17/2016

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Directions to “ DR. JOHN CHARLES ROCK MD” Practice Location

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