Individual
BROCK J DOUBLEDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 W 22ND, SIOUX FALLS, SD 57105-1521
(605) 312-1000
(605) 312-1001
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 312-1000
(605) 312-1001
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
47322
MN
2080P0206X
Pediatric Gastroenterology Physician
Primary
5852
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620933500
—
MN
Enumeration date
12/22/2005
Last updated
04/04/2022
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