MEDICARE: STEVEN M COCKING PAC

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	363A00000X	Physician Assistant	2054	AZ

General Provider Information

NPI Number	:	1457430381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN M COCKING PAC

Provider Business Mailing Address
First Line	:	4340 E INDIAN SCHOOL RD
Second Line	:	STE 21-562
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5360
Country	:	US
Telephone Number	:	480-545-2610
Fax Number	:	480-545-2673

Provider Business Practice Location Address
First Line	:	4340 E INDIAN SCHOOL RD
Second Line	:	STE 21-562
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5360
Country	:	US
Telephone Number	:	480-545-2610
Fax Number	:	480-545-2673

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	01/13/2015

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Directions to “ STEVEN M COCKING PAC” Practice Location

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