MEDICARE: DR. WILLIAM DAVID BROCK PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1399	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	O39287	OTHER		ANTHEM PROVIDER NUMBER

General Provider Information

NPI Number	:	1336161520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM DAVID BROCK PH.D.

Provider Business Mailing Address
First Line	:	1241 MALL DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-4737
Country	:	US
Telephone Number	:	804-794-8828
Fax Number	:	804-794-4735

Provider Business Practice Location Address
First Line	:	1241 MALL DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-4737
Country	:	US
Telephone Number	:	804-794-8828
Fax Number	:	804-794-4735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/09/2007

Similar Medicare Providers

1295786390 — DR. TERESA ANN BUCZEK PH,D.
Practice Location Address:

1241 MALL DR
RICHMOND, VA
23235-4737

Practice Phone: 804-794-5928
Practice Fax: 804-379-6385

1124073853 — MICHAEL DORIAN SMITH PHD
Practice Location Address:

1241 MALL DR
RICHMOND, VA
23235-4737

Practice Phone: 804-794-8828
Practice Fax:

1962515114 — MS. PATRICIA LEIGH WINTERBERGER BROCK LPC
Practice Location Address:

1241 MALL DR
RICHMOND, VA
23235-4737

Practice Phone: 804-306-8458
Practice Fax: 804-794-4735

1982277117 — DR. KIMONE LATOYA JOHNS DNP, FNP-BC, PMHNP-B
Practice Location Address:

1233 MALL DR
NORTH CHESTERFIELD, VA
23235-4737

Practice Phone: 917-856-6295
Practice Fax:

1790058899 — DR. ALAN THOMAS VON KLEISS PSYD
Practice Location Address:

1215 MALL DR
NORTH CHESTERFIELD, VA
23235-4737

Practice Phone: 804-594-3690
Practice Fax: 804-794-7374

1326415837 — DR. RAE-ANNE DOUGAN
Practice Location Address:

1215 MALL DR
NORTH CHESTERFIELD, VA
23235-4737

Practice Phone: 804-594-3960
Practice Fax:

Directions to “ DR. WILLIAM DAVID BROCK PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.