Individual provider Active NPI

Brian John Bock, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tulsa, OK
National Provider Identifier
1922020213
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
21665 Issued in OK
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 744-2553
Fax
(918) 744-3482
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 21665 OK Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 04-28663 KS

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-28663KSMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1922020213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2553",
            "fax_number": "918-744-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2553",
            "fax_number": "918-744-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "BRIAN",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OK",
            "license": "21665",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "04-28663",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.