Brock, James Benjamin

Brock, James Benjamin is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Brock, James Benjamin can be contacted via phone (601) 984-5560.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5560
Fax: (601) 984-5565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 21425 Mississippi
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 21425 Mississippi
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 21425 Mississippi

Profile Details

NPI number 1073742607
LBN Legal business name Brock, James Benjamin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2009
Last updated Oct 31st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073742607 NPPES
Mississippi MEDICAID 03679540
Mississippi Other P01667060

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