Brock Medical, Llc | |
1649 Highway 192 W London KY 40741-1674 | |
(931) 253-1110 | |
(931) 253-1110 |
Full Name | Brock Medical, Llc |
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Speciality | Clinic/Center |
Location | 1649 Highway 192 W, London, 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 306505 Nashville TN 37230-6505 Ph: (931) 253-1110 | Brock Medical, Llc 1649 Highway 192 W London KY 40741-1674 Ph: (931) 253-1110 |
NPI Number | 1063295442 |
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Provider Enumeration Date | 08/17/2023 |
Last Update Date | 08/17/2023 |
Medicare PECOS PAC ID | 9830354638 |
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Medicare Enrollment ID | O20230908000497 |
Identifier | Type | State | Issuer |
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1063295442 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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