Brock, Ronald Leroy

Brock, Ronald Leroy is an individual health care provider with primary practice located at 660 Lanier Park Drive Ste A, Gainesville GA 30501-2075. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brock, Ronald Leroy can be contacted via phone (770) 535-0000.

Contact Information

Primary practice address
660 Lanier Park Drive Ste A Gainesville GA 30501-2075
Phone: (770) 535-0000
Fax: (770) 532-3911
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 045044 Georgia
Allopathic & Osteopathic Physicians / Urology 208800000X 45044 Georgia

Profile Details

NPI number 1114926912
LBN Legal business name Brock, Ronald Leroy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Dec 9th, 2015 - about 10 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 1114926912 NPPES
Georgia MEDICAID 00877632A

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