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NPI Code Detail

MEDICARE: JESSICA TAYLOR BROCK DO

MEDICARE: JESSICA TAYLOR BROCK DO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1679414254
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA TAYLOR BROCK DO
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 866-320-4573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ JESSICA TAYLOR BROCK DO” Practice Location

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