Provider Demographics
NPI:1265750251
Name:BARRY BOCKOW MD PS
Entity type:Organization
Organization Name:BARRY BOCKOW MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCKOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-246-7880
Mailing Address - Street 1:16122 8TH AVE SW
Mailing Address - Street 2:SUITE D3
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2967
Mailing Address - Country:US
Mailing Address - Phone:206-246-7880
Mailing Address - Fax:206-246-4272
Practice Address - Street 1:16122 8TH AVE SW
Practice Address - Street 2:SUITE D3
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2967
Practice Address - Country:US
Practice Address - Phone:206-246-7880
Practice Address - Fax:206-246-4272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty