Individual
THOMAS J POCKAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 EAST BROADWAY, SUITE 202, JACKSON, WY 83001
(307) 733-6520
(307) 733-3216
Mailing address
PO BOX 4182, JACKSON, WY 83001-4182
(307) 733-6520
(307) 733-3216
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3222A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101962700
—
WY
05
—
805096800
—
ID
Enumeration date
01/24/2007
Last updated
07/08/2007
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