Provider Demographics
NPI:1346556529
Name:WILLIAM BOCK OD PA
Entity Type:Organization
Organization Name:WILLIAM BOCK OD PA
Other - Org Name:BILL BOCK OD PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD PA
Authorized Official - Phone:863-648-0222
Mailing Address - Street 1:PO BOX 6216
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33807-6216
Mailing Address - Country:US
Mailing Address - Phone:863-648-0222
Mailing Address - Fax:863-648-0200
Practice Address - Street 1:6745 N CHURCH AVE
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:FL
Practice Address - Zip Code:33860-2080
Practice Address - Country:US
Practice Address - Phone:863-648-0222
Practice Address - Fax:863-648-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC701152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty