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Individual

DR. JAMES MURRAY BROCK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
136 MARION AVE, MCCOMB, MS 39648-3620
(601) 684-3210
(601) 684-3319
Mailing address
136 MARION AVE, MCCOMB, MS 39648-3620
(601) 684-3210
(601) 684-3319

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
07285
MS
207ND0101X
MOHS-Micrographic Surgery Physician
07285
MS
207NS0135X
Procedural Dermatology Physician
07285
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00115075
MS
Enumeration date
03/05/2007
Last updated
11/03/2020
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