Individual
BART J DEBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
328 N 2ND ST STE 200, VINCENNES, IN 47591-1353
(812) 882-4320
(812) 882-2706
Mailing address
328 N 2ND ST STE 200, VINCENNES, IN 47591-1353
(812) 882-4320
(812) 882-2706
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01044481
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086989
ANTHEM
IN
05
—
200076370
—
IN
Enumeration date
09/22/2005
Last updated
03/21/2024
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