Mock, Theron Clay
Mock, Theron Clay is an sole proprietor health care provider with primary practice located at 465 Gypsy Ln Apt 312, Youngstown OH 44504-1361. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mock, Theron Clay can be contacted via phone (330) 746-5111.Contact Information
Primary practice address
465 Gypsy Ln Apt 312
Youngstown OH 44504-1361
Phone: (330) 746-5111
Fax: (330) 746-5111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 35-04-5230 | Ohio |
Profile Details
| NPI number | 1932319894 |
|---|---|
| LBN Legal business name | Mock, Theron Clay |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932319894 | NPPES |
| Ohio | MEDICAID | 0976412 |
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