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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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 1609885805 NPPES
Arkansas MEDICAID 154129001
Arkansas Other DE6376

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