Individual
DR. JACOB A MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCGP
Contact information
Practice address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-6606
Mailing address
1650 COWLES ST, FAIRBANKS MEMORIAL HOSPITAL, FAIRBANKS, AK 99701
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
102058
AK
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0013183
OR
Other
Enumeration date
06/10/2009
Last updated
03/29/2021
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