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NPI Code Detail

MEDICARE: BROCK EMERGENCY PHYSICIANS

MEDICARE: BROCK EMERGENCY PHYSICIANS
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000175329OTHERINBLUE SHIELD

General Provider Information

NPI Number : 1659543536
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROCK EMERGENCY PHYSICIANS
Provider Business Mailing Address
First Line : PO BOX 8050
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-8050
Country : US
Telephone Number : 800-732-1066
Fax Number : 630-941-4333
Provider Business Practice Location Address
First Line : 911 N SHELBY ST
Second Line :
City : SALEM
State : IN
Zip : 47167-2304
Country : US
Telephone Number : 812-883-5881
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DOUGLAS WEBSTER
Credential :
Telephone Number : 800-355-0808
Provider Enumeration Date : 03/31/2008
Last Update Date : 04/20/2008

Similar Medicare Providers

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Practice Location Address:
911 N SHELBY ST
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Practice Fax:
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1477729234 — DR. ABDELRAHMAN M ABDALLA MD
Practice Location Address:
911 N SHELBY ST
SALEM, IN
47167-2304
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1821223439 — CRITICAL ACCESS HEALTH SERVICES CORP.
Practice Location Address:
911 N SHELBY ST
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Practice Fax:
1497987259 — WASHINGTON COUNTY EMERGENCY MEDICAL SERVICES, INC.
Practice Location Address:
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Directions to “BROCK EMERGENCY PHYSICIANS ” Practice Location

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