Provider Demographics
NPI:1033371513
Name:ROCK, FREDERICK C (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:C
Last Name:ROCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 CASTELAR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3146
Mailing Address - Country:US
Mailing Address - Phone:402-408-2102
Mailing Address - Fax:
Practice Address - Street 1:9825 GILES RD
Practice Address - Street 2:SUITE F
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2927
Practice Address - Country:US
Practice Address - Phone:402-339-2283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26260208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice