Individual
DR. REGINA LYNN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
858 EASTERN BYP, RICHMOND, KY 40475-2512
(859) 626-0072
(859) 626-9684
Mailing address
858 EASTERN BYP, RICHMOND, KY 40475-2512
(859) 626-0072
(859) 626-9684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34004
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34204
MED LIC (KY BOARD OF MED)
KY
05
—
64050768
—
KY
Enumeration date
08/31/2006
Last updated
03/07/2023
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