Organization
BROCK EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS WEBSTER (OWNER)
(800) 355-0808
Entity
Organization
Contact information
Practice address
911 N SHELBY ST, SALEM, IN 47167-2304
(812) 883-5881
Mailing address
PO BOX 8050, PHILADELPHIA, PA 19101-8050
(800) 732-1066
(630) 941-4333
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175329
BLUE SHIELD
IN
Enumeration date
03/31/2008
Last updated
04/20/2008
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