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NPI Code Detail

MEDICARE: MR. ROBERT EDWARD JOCK PA-C

MEDICARE: MR. ROBERT EDWARD JOCK PA-C
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
1363A00000XPhysician Assistant5601006165MI

General Provider Information

NPI Number : 1548542178
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT EDWARD JOCK PA-C
Provider Business Mailing Address
First Line : 3404 PATIENT CARE DR
Second Line :
City : LANSING
State : MI
Zip : 48911-4217
Country : US
Telephone Number : 517-267-0200
Fax Number : 517-267-1877
Provider Business Practice Location Address
First Line : 3404 PATIENT CARE DR
Second Line :
City : LANSING
State : MI
Zip : 48911-4217
Country : US
Telephone Number : 517-267-0200
Fax Number : 517-267-1877
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2011
Last Update Date : 05/14/2026

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Directions to “ MR. ROBERT EDWARD JOCK PA-C” Practice Location

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