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Individual

JOSEPH L BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
246 GRANGER RD, SUITE 2, BARRE, VT 05641-5344
(802) 225-5810
(802) 371-4821
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-5810
(802) 371-4821

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042.0011623
VT
207Q00000X
Family Medicine Physician
4301047460
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0806100351
BLUE CROSS BLUE SHIELD
MA
01
0806100351
BLUE CARE NETWORK
MI
01
101317
PREFERRED CHOICES
MI
05
1015396
VT
01
300207909004
TRICARE
MI
01
34918
HEALTH PLAN OF MI
MA
01
4556208
MOLINA HEALTHCARE
MI
05
4556208
MI
01
5621038
AETNA
MI
01
6589077
CIGNA
MI
01
A74772
PRIORITY HEALTH
MI
01
P00091158
RAILROAD MEDICARE
MI
Enumeration date
02/24/2006
Last updated
12/04/2014
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