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NPI Code Detail

MEDICARE: DR. RANDALL BOCK M.D.

MEDICARE: DR. RANDALL BOCK M.D.
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
1208D00000XGeneral Practice Physician51810MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205991031
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL BOCK M.D.
Provider Business Mailing Address
First Line : 1660 SOLDIERS FIELD RD # 1021
Second Line :
City : BRIGHTON
State : MA
Zip : 02135-1108
Country : US
Telephone Number : 617-901-4847
Fax Number :
Provider Business Practice Location Address
First Line : 465 S WASHINGTON ST
Second Line :
City : NORTH ATTLEBORO
State : MA
Zip : 02760-2159
Country : US
Telephone Number : 508-316-0725
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 12/01/2022

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Directions to “ DR. RANDALL BOCK M.D.” Practice Location

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