Individual
MR. RONALD LEROY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
660 LANIER PARK DRIVE, STE A, GAINESVILLE, GA 30501-2075
(770) 535-0000
(770) 532-3911
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
045044
GA
208800000X
Urology Physician
Primary
45044
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00877632A
—
GA
Enumeration date
07/14/2005
Last updated
12/09/2015
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