Individual
ROBERT C BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 751-3722
(479) 751-1099
Mailing address
601 W MAPLE AVE STE 503, SPRINGDALE, AR 72764-5376
(479) 751-3722
(479) 751-1099
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COO156
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100786670A
—
OK
05
—
112044001
—
AR
01
—
771011201
ARKANSAS BREASTCARE
AR
Enumeration date
03/25/2006
Last updated
09/23/2019
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