Individual
DR. TERESA A MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
621 S ILLINOIS AVE, SUITE 100, MASON CITY, IA 50401-5489
(641) 422-6900
(641) 422-6909
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 494-3041
(641) 494-3059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26090
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04836
WELLMARK
IA
05
—
2249078
—
IA
Enumeration date
08/31/2006
Last updated
08/22/2022
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