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NPI Code Detail

MEDICARE: JAMES E. MOCK MD

MEDICARE: JAMES E. MOCK 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
1174400000XSpecialist7780NV
2207RC0000XCardiovascular Disease Physician7780NV

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 : 1417046822
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES E. MOCK MD
Provider Business Mailing Address
First Line : 700 E SILVERADO RANCH BLVD STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-7518
Country : US
Telephone Number : 702-240-6482
Fax Number :
Provider Business Practice Location Address
First Line : 2800 N TENAYA WAY
Second Line : SUITE 202
City : LAS VEGAS
State : NV
Zip : 89128-1100
Country : US
Telephone Number : 702-255-8877
Fax Number : 702-255-8813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/28/2022

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