Provider Demographics
NPI:1982984373
Name:ERICH V. BOCK, D.P.M., P.C.
Entity Type:Organization
Organization Name:ERICH V. BOCK, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.M / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:V
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:520-299-1477
Mailing Address - Street 1:PO BOX 43160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3160
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:7320 N LA CHOLLA BLVD
Practice Address - Street 2:#154-214
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2309
Practice Address - Country:US
Practice Address - Phone:520-219-1477
Practice Address - Fax:520-797-1254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ138213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPENDINGMedicare PIN
AZT41410Medicare UPIN