Provider Demographics
NPI:1992875694
Name:HOCK, JOSEPH M (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:HOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 BAYMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7690
Mailing Address - Country:US
Mailing Address - Phone:678-714-1641
Mailing Address - Fax:
Practice Address - Street 1:3703 WINDER HWY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-3015
Practice Address - Country:US
Practice Address - Phone:770-532-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA006952OtherLICENSE #
GAU99853Medicare UPIN
GA006952OtherLICENSE #