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1205959475

NPI Code Detail

MEDICARE: DR. GARY CRAIG MOCKLI

MEDICARE: DR. GARY CRAIG MOCKLI

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	114040	MO
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	23146	NE
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	E-1874	AR
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	G63829	CA
5	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0431136	KS
6	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	01048819A	IN
7	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	5994	SD
8	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD00044754	WA
9	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	37009	IA
10	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25391	OK
11	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD0000041798	TN
12	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician		IL

General Provider Information

NPI Number	:	1205959475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY CRAIG MOCKLI

Provider Business Mailing Address
First Line	:	2040 CONCOURSE DR
Second Line	:	QUEST DIAGNOSTICS
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4119
Country	:	US
Telephone Number	:	314-872-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 CONCOURSE DR
Second Line	:	QUEST DIAGNOSTICS
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4119
Country	:	US
Telephone Number	:	314-872-3733
Fax Number	:

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. GARY CRAIG MOCKLI ” Practice Location

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