Brock Medical, Llc | |
60 Fitz Gilbert Rd Hazard KY 41701-5336 | |
(859) 398-2001 | |
Not Available |
Full Name | Brock Medical, Llc |
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Speciality | Clinic/Center |
Location | 60 Fitz Gilbert Rd, Hazard, 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 |
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Brock Medical, Llc Po Box 306414 Nashville TN 37230-6414 Ph: (859) 398-2001 | Brock Medical, Llc 60 Fitz Gilbert Rd Hazard KY 41701-5336 Ph: (859) 398-2001 |
NPI Number | 1306568167 |
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Provider Enumeration Date | 09/16/2022 |
Last Update Date | 09/16/2022 |
Medicare PECOS PAC ID | 9830354638 |
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Medicare Enrollment ID | O20221028002756 |
Identifier | Type | State | Issuer |
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1306568167 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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