Dale L Mock (NPI# 1215948351, PAC ID# 6204853633) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1215948351 |
| PAC ID by PECOS | 6204853633 |
| Professional Enrollment ID | I20051101000080 |
| Full Name | Dale L Mock |
| Organization Legal Name | BOISE FAMILY MEDICINE CENTER |
| Address |
10798 W Overland Rd Boise ID 83709-1329 |
| Phone Number | 2083773368 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
| Graduation Year | 1969 |
| Primary Specialty | FAMILY PRACTICE |
| Secondary Specialties | GENERAL PRACTICE |
| Group Practice PAC ID | 7113944547 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130007 | ST ALPHONSUS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10798 W Overland Rd, Boise, ID 83709-1329 | 2083773368 | BOISE FAMILY MEDICINE CENTER |
| 10798 W Overland Rd, Boise, ID 83709-1329 | BOISE FAMILY MEDICINE, LLC |
| Organization Legal Name | BOISE FAMILY MEDICINE CENTER |
| Physicians | 1 |
| Street Address |
10798 W OVERLAND RD |
| City | BOISE |
| State | ID |
| Zip | 83709-1329 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth B Judy | Physician Assistant | Boise Family Medicine, LLC | 10798 W Overland Rd, Boise, ID 83709-1329 |
| Kirk A Campana | Family Medicine | Boise Family Medicine, LLC | 10798 W Overland Rd, Boise, ID 83709-1329 |
| Tara J Brumpton | Physician Assistant | Boise Family Medicine, LLC | 10798 W Overland Rd, Boise, ID 83709-1329 |
| Jon R Fox | Physician Assistant | Boise Family Medicine, LLC | 10798 W Overland Rd, Boise, ID 83709-1329 |
| Stephanie K Potter | Family Practice | Boise Family Medicine, LLC | 10798 W Overland Rd, Boise, ID 83709-1329 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer J Gooding | Nurse Practitioner | First Choice Healthcare, Inc. | 12400 W Overland Rd, Suite 100, Boise, ID 83709-0021 |
| Candice Elaine Adams | Nurse Practitioner | First Choice Healthcare, Inc. | 12400 W Overland Rd, Suite 100, Boise, ID 83709-0021 |
| Kevin A Clifford | Hospice/palliative Care | First Choice Healthcare, Inc. | 12400 W Overland Rd, Suite 100, Boise, ID 83709-0021 |
| Michelle Clapperton | Nurse Practitioner | First Choice Healthcare, Inc. | 12400 W Overland Rd, Suite 100, Boise, ID 83709-0021 |
| Neil E King | Chiropractic | 10826 W Ashburton Dr, Boise, ID 83709-0225 | |
| Brenda Dee | Clinical Social Worker | 7229 W Franklin Rd, Boise, ID 83709-0909 | |
| Jamia E Byrns | Internal Medicine | Lyon Medical LLC | 6651 W Franklin Rd, Boise, ID 83709-0914 |
| Stephanie L Dalton | Physician Assistant | Lyon Medical LLC | 6651 W Franklin Rd, Boise, ID 83709-0914 |
| Kimberly Hinrichs | Clinical Social Worker | 204 S Cole Rd, Boise, ID 83709-0934 | |
| Christina M Smith | Clinical Social Worker | 204 S Cole Rd, Boise, ID 83709-0934 | |
| Find all physicians in zip 83709 | |||
| City | BOISE |
| Zip Code | 83709 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | BOISE + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Dale L Mock.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.