| Brock Medical, Llc | |
|
521 E. Cumberland Gap Pkwy. Suite 1 Corbin KY 40701-2050 | |
| (606) 261-2054 | |
| Not Available |
| Full Name | Brock Medical, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 521 E. Cumberland Gap Pkwy., Corbin, Kentucky |
| Authorized Official Name and Position | Sydni Clemmons (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9013511791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brock Medical, Llc Po Box 306505 Nashville TN 37230-6505 Ph: (931) 253-1110 | Brock Medical, Llc 521 E. Cumberland Gap Pkwy. Suite 1 Corbin KY 40701-2050 Ph: (606) 261-2054 |
| NPI Number | 1669256913 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 08/18/2023 |
| Medicare PECOS PAC ID | 9830354638 |
|---|---|
| Medicare Enrollment ID | O20230911000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669256913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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