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Individual

MR. JAMES ALBERT BROCK III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3104 BLUE LAKE DR STE 110, VESTAVIA, AL 35243-2372
(205) 977-1949
Mailing address
3104 BLUE LAKE DR STE 110, VESTAVIA, AL 35243-2372
(205) 977-1949

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
123925
AL
207L00000X
Anesthesiology Physician
AC004133
MD

Other

Enumeration date
01/01/2019
Last updated
02/28/2022
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