Healthcare Provider Details

I. General information

NPI: 1720609910
Provider Name (Legal Business Name): WILLIAM COZEAN DEBROCK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FIRST VILLAGE DR
PINEHURST NC
28374-9495
US

IV. Provider business mailing address

5 FIRST VILLAGE DR
PINEHURST NC
28374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-0878
  • Fax: 910-295-0878
Mailing address:
  • Phone: 910-295-0878
  • Fax: 910-295-0878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number2026-00843
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: