Brock, Kenneth W

Brock, Kenneth W is an individual health care provider with primary practice located at 3535 Southern Blvd , Kettering OH 45429-1221. He recently has only one registered license in Emergency Medical Service Providers / Personal Emergency Response Attendant, which is considered as his primary health care specialty. Brock, Kenneth W can be contacted via phone (937) 395-8166.

Contact Information

Primary practice address
3535 Southern Blvd Kettering OH 45429-1221
Phone: (937) 395-8166
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X 35037259 Ohio

Profile Details

NPI number 1942286851
LBN Legal business name Brock, Kenneth W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jul 8th, 2007 - about 18 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 1942286851 NPPES
Ohio MEDICAID 0251614

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