Provider Demographics
NPI:1992978555
Name:HOCKER, DAVID LEON (MD MRO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEON
Last Name:HOCKER
Suffix:
Gender:M
Credentials:MD MRO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 JESSE JEWELL PKWY SE
Mailing Address - Street 2:SUITE #370
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3862
Mailing Address - Country:US
Mailing Address - Phone:770-536-1004
Mailing Address - Fax:770-536-0905
Practice Address - Street 1:1240 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE #370
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3862
Practice Address - Country:US
Practice Address - Phone:770-536-1004
Practice Address - Fax:770-536-0905
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041138207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00089388OtherMEDICARE RAILROAD
GA1992978555OtherBLUE CROSS AND BLUE SHIEL
GA158736300OtherHEALTHLINK
GA1992978555OtherBLUE CROSS AND BLUE SHIEL
GAP00089388OtherMEDICARE RAILROAD