| Robert J Brock Md Pa | |
|
2420 East 25th Circle Suite B Idaho Falls ID 83404-7549 | |
| (208) 525-3220 | |
| (208) 525-3227 |
| Full Name | Robert J Brock Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2420 East 25th Circle, Idaho Falls, Idaho |
| Authorized Official Name and Position | Robert J Brock (PRESIDENT) |
| Authorized Official Contact | 2085253220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert J Brock Md Pa Po Box 3070 Idaho Falls ID 83403-3070 Ph: (208) 525-3220 | Robert J Brock Md Pa 2420 East 25th Circle Suite B Idaho Falls ID 83404-7549 Ph: (208) 525-3220 |
| NPI Number | 1972643997 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 12/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972643997 | NPI | - | NPPES |
| 8055716000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M7908 (Idaho) | Primary |
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