Brock, Paul Bennett
Brock, Paul Bennett is an individual health care provider with primary practice located at 1825 Martha Berry Blvd Nw , Rome GA 30165-1625. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Brock, Paul Bennett can be contacted via phone (706) 295-5331.Contact Information
Primary practice address
1825 Martha Berry Blvd Nw
Rome GA 30165-1625
Phone: (706) 295-5331
Fax: (706) 236-6432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 026466 | Georgia |
Profile Details
| NPI number | 1790845048 |
|---|---|
| LBN Legal business name | Brock, Paul Bennett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 9th, 2006 |
| Last updated | Mar 23rd, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790845048 | NPPES |
| Georgia | MEDICAID | 000368167A |
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