Individual
DR. GREGORY K BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1436 LOCUST ST, TERRE HAUTE, IN 47807-1648
(812) 232-7447
(812) 232-6962
Mailing address
1436 LOCUST ST, TERRE HAUTE, IN 47807-1648
(812) 232-7447
(812) 232-6962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001784
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080190613
RAILROAD MEDICARE
IN
05
—
200179390
—
IN
01
—
P00950465
RAILROAD
IN
Enumeration date
02/10/2006
Last updated
11/24/2014
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