Individual
DR. MITCHELL VERNON BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3025 SHRINE RD, SUTIE 190, BRUNSWICK, GA 31520-4788
(912) 466-7250
(912) 466-7253
Mailing address
3025 SHRINE RD, SUTIE 190, BRUNSWICK, GA 31520-4788
(912) 466-7250
(912) 466-7253
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
051407
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000961958C
—
GA
Enumeration date
07/14/2006
Last updated
09/18/2023
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