Individual
DR. LARRY DALE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5901 AIRPORT BLVD, SUITE E, MOBILE, AL 36608-3169
(251) 342-0505
(251) 342-0360
Mailing address
5809 FAIRFAX RD S, MOBILE, AL 36608-2938
(251) 343-1598
(251) 342-0360
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
5347
AL
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
5347
AL
Other
Enumeration date
05/30/2007
Last updated
11/21/2008
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