Provider Demographics
NPI:1508879925
Name:MOCK, WILLIAM EDWARD (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:MOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2871 CORPORATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-7250
Mailing Address - Country:US
Mailing Address - Phone:334-887-2020
Mailing Address - Fax:334-887-2030
Practice Address - Street 1:2871 CORPORATE PARK DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-7250
Practice Address - Country:US
Practice Address - Phone:334-887-2020
Practice Address - Fax:334-887-2030
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00005394207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000004428Medicaid
AL051004428OtherBLUE CROSS OF ALABAMA
630691977OtherCIGNA HEALTHCARE
0800338OtherUNITED HEALTHCARE
AL000075538Medicaid
AL051075538OtherBLUE CROSS OF ALABAMA
18003913ZOtherMEDICARE RAILROAD
AL75538MOCMedicare ID - Type Unspecified
AL04428MOCMedicare ID - Type Unspecified
AL051004428OtherBLUE CROSS OF ALABAMA