Individual
WADE DALE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 S SHACKLEFORD RD STE 220, LITTLE ROCK, AR 72211-3847
(501) 223-2244
(501) 223-2231
Mailing address
900 S SHACKLEFORD RD STE 220, LITTLE ROCK, AR 72211-3847
(501) 223-2244
(501) 223-2231
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
E2380
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006834
HUMANA
AR
05
—
154129001
—
AR
Enumeration date
08/05/2006
Last updated
05/22/2025
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