Individual
DR. EDSON BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13781 JORDAN MEADOWS LN, NOKESVILLE, VA 20181-2944
(828) 506-9113
Mailing address
13781 JORDAN MEADOWS LN, NOKESVILLE, VA 20181-2944
(828) 506-9113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101249259
VA
207P00000X
Emergency Medicine Physician
42061
TN
207P00000X
Emergency Medicine Physician
99-00173
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1197P
BCBS OF NC
—
05
—
891197P
—
NC
05
—
N00175
—
SC
01
—
P00057389
RAILROAD
—
Enumeration date
06/06/2006
Last updated
02/24/2015
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