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General NPI Number Information
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NPI Number | 1811904485
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Entity Type | Individual
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Provider Name | SCOTT A BROCK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 1000 LANGWORTHY ST
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City | DUBUQUE
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State | IA
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Zip | 52001-7313
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Country | US
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Telephone | 563-584-4430
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Fax | 563-584-4295
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Provider Business Mailing Address
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Address Line | 1500 ASSOCIATES DR
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City | DUBUQUE
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State | IA
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Zip | 52002-2201
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Country | US
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Telephone | 563-584-4100
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Fax | 563-584-4110
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 36819
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License Number State | IA
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