Organization
BRIAN P. BROCKER M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN P. BROCKER M.D. (PRESIDENT/OWNER)
(330) 747-9215
Entity
Organization
Contact information
Practice address
1616 COVINGTON ST, YOUNGSTOWN, OH 44510-1244
(330) 747-9215
(330) 747-9248
Mailing address
1616 COVINGTON ST, YOUNGSTOWN, OH 44510-1244
(330) 747-9215
(330) 747-9248
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-066899
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000106032
UNISON
OH
01
—
000000138342
ANTHEM
OH
05
—
0215672
—
OH
01
—
0600127
UNITED HEALTHCARE
OH
01
—
1507678
GATEWAY
OH
01
—
28552021500
BWC PROVIDER #
OH
01
—
285520215001
MEDICAL MUTUAL-YNGS LOC
OH
01
—
285520215005
MEDICAL MUTUAL-WARREN LOC
OH
01
—
4597438
AETNA
OH
01
—
7405468
CIGNA
OH
01
—
9282451
MEDICARE-WARREN
OH
01
—
9282452
MEDICARE-YNGS
OH
Enumeration date
09/28/2007
Last updated
07/16/2009
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