Organization
HOWARD R BROCK M.D.
Active
Other names
Dayton Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD R BROCK MD (OWNER)
(423) 570-7005
Entity
Organization
Contact information
Practice address
1436 RAILROAD ST, DAYTON, TN 37321-1234
(423) 570-7005
Mailing address
1436 RAILROAD ST, DAYTON, TN 37321-1234
(423) 570-7005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000036269
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3357233
CIGNA
TN
01
—
4095858
BLUE CROSS
TN
01
—
702025457
CARITEN
TN
01
—
P00190427
RAILROAD MEDICARE
TN
01
—
TN0101
UNITED HEALTHCARE OF THE RIVER VALLEY
TN
Enumeration date
06/19/2008
Last updated
06/29/2015
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