Individual
DR. HOWARD THOMAS BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
914 BROAD ST, STE 2A, KINGSPORT, TN 37660-3817
(423) 245-6101
(423) 245-2396
Mailing address
914 BROAD ST, STE 2A, KINGSPORT, TN 37660-3817
(423) 245-6101
(423) 245-2396
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD11147
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060917
BCBS TENNESSEE
TN
01
—
033503
ANTHEM BCBS OF VIRGINIA
VA
01
—
20009691
RAILROAD MEDICARE
TN
05
—
3173373
—
TN
01
—
5961032
AETNA
—
01
—
7305605
VIRGINIA MEDICAID
VA
Enumeration date
07/05/2006
Last updated
12/05/2007
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