Brock, Wade Dale
Brock, Wade Dale is an sole proprietor health care provider with primary practice located at 9800 Baptist Health Dr Ste 500 , Little Rock AR 72205-6243. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Brock, Wade Dale can be contacted via phone (501) 223-2244.Contact Information
Primary practice address
9800 Baptist Health Dr Ste 500
Little Rock AR 72205-6243
Phone: (501) 223-2244
Fax: (501) 223-2231
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery | 207WX0200X | E2380 | Arkansas |
Profile Details
NPI number | 1609885805 |
---|---|
LBN Legal business name | Brock, Wade Dale |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 5th, 2006 |
Last updated | Mar 14th, 2024 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1609885805 | NPPES |
Arkansas | MEDICAID | 154129001 | |
Arkansas | Other | DE6376 |
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