1679509608 NPI number — DR. KARIN B ROCK M.D.

Table of content: DR. KARIN B ROCK M.D. (NPI 1679509608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679509608 NPI number — DR. KARIN B ROCK M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROCK
Provider First Name:
KARIN
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679509608
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 741814
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-1814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-995-2260
Provider Business Mailing Address Fax Number:
205-980-0133

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 MISSIONARY RDG
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-5255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-995-2260
Provider Business Practice Location Address Fax Number:
205-980-0133
Provider Enumeration Date:
06/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  00009791 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 511-19130 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51505173 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".