Provider Demographics
NPI:1669461620
Name:ROCK, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
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:PO BOX 17527
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-7527
Mailing Address - Country:US
Mailing Address - Phone:406-728-8420
Mailing Address - Fax:
Practice Address - Street 1:3550 MULLAN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-5168
Practice Address - Country:US
Practice Address - Phone:406-728-8420
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9863207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0040018Medicaid
MT0040018Medicaid