Wade Dale Brock in Little Rock - Ophthalmic Plastic And Reconstructive Surgery
Wade Dale Brock - NPI 1609885805
Wade Dale Brock is a Ophthalmic Plastic And Reconstructive Surgery in Little Rock, Arkansas. Wade Dale Brock practices all healthcare services and medical treatments related to Ophthalmic Plastic And Reconstructive Surgery. The NPI Number for Wade Dale Brock is 1609885805. The last update date is 2017-12-13.
Wade Dale Brock's current location address is 9800 Lile Dr, Little Rock, Arkansas. You can contact this provider via phone number 5012232244 and fax number 5012232231. The mailing address for Wade Dale Brock is 9800 Lile Dr, Little Rock, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wade Dale Brock |
|---|---|
| Address | 9800 Lile Dr, Little Rock, Arkansas |
| Phone Number | 5012232244 |
| Fax Number | 5012232231 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1609885805 |
|---|---|
| Provider Enumeration Date | 2006-08-05 |
| Last Updated Date | 2017-12-13 |
Provider Mailing Address Detail
| Address | 9800 Lile Dr |
|---|---|
| City | Little Rock |
| State | Arkansas (AR) |
| Post Code | 722056229 |
| Phone Number | 5012232244 |
| Fax Number | 5012232231 |
Provider's Primary Taxonomy Detail
| Speciality | Ophthalmic Plastic And Reconstructive Surgery |
|---|---|
| Taxonomy | 207Wx0200X |
| Licence No | E2380 |
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Definition: A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and la |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| DE6376 | AR | RAILROAD MEDICARE | |
| 154129001 | AR | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Wade Dale Brock by the Centers for Medicare & Medicaid Services?
The Wade Dale Brock has been assigned the NPI (National Provider Identifier) 1609885805 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Wade Dale Brock's facilities are geographically located?
The facilities of Wade Dale Brock are physically situated at the following location: 9800 Lile Dr, Little Rock, AR, 722056229.
What is Wade Dale Brock's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Wade Dale Brock is Ophthalmic Plastic And Reconstructive Surgery, and the taxonomy code that classifies this field of practice is 207Wx0200X.
On what date did the Wade Dale Brock receive its 1609885805 assignment from the Centers for Medicare & Medicaid Services?
The Wade Dale Brock was assigned its 1609885805 by the Centers for Medicare & Medicaid Services on 2006-08-05.
As of what date were the details related to Wade Dale Brock most recently updated or revised?
The information pertaining to Wade Dale Brock, including its address, specialty, and other relevant details, was last updated or revised on 2017-12-13.