# BROCK SURGICAL GROUP, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891204533
- **Authorized official:** JUSTIN LECOMPTE (MANAGER)
- **Authorized official phone:** (480) 213-8488

## Contact information

- **Practice address:** 10255 N 32ND ST, PHOENIX, AZ 85028-3822
- **Practice address phone:** (480) 213-8488
- **Mailing address:** 835 W WARNER RD STE 101-462, GILBERT, AZ 85233-7297
- **Mailing address phone:** (480) 213-8488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | OSC-17-1451 | AZ | Yes |

## Other

- **Enumeration date:** 09/26/2017
- **Last updated:** 07/21/2022