Provider Demographics
NPI:1730145939
Name:BOCAN, DAN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:
Last Name:BOCAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HOSPITAL DR.
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-0629
Mailing Address - Country:US
Mailing Address - Phone:870-235-3452
Mailing Address - Fax:870-235-3667
Practice Address - Street 1:101 HOSEPITAL DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-0629
Practice Address - Country:US
Practice Address - Phone:870-235-3452
Practice Address - Fax:870-235-3667
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC152207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59584Medicare ID - Type Unspecified