Charles A Brock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-524-TA-199 Issued in AL

Practice address

790 Montgomery Hwy Ste 110
Vestavia Hills, AL 35216-1873

Phone

(205) 823-4555

Fax

(205) 823-1881

NPI assigned

Sep 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386747483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2473 HACKWORTH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352141909",
            "telephone_number": "205-798-3033",
            "fax_number": "205-798-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 MONTGOMERY HWY STE 110",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352161873",
            "telephone_number": "205-823-4555",
            "fax_number": "205-823-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-524-TA-199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leann Marie Brakke, LPC, MS, NBCC
• Kenneth Wayne Bramlett, M.D.
• John Russell Brazelton, DPT
• Shenika Brewer, LPC
• Mary Virginia Briley
• Kelsey Farley Brock, LPC
• Abigail Anne Brown, RN
• Clark C. Browne, DMD
• Clark Clayton Browne Jr., DMD
• Leah Brownell, RBT

• Optometrist in Vestavia Hills, AL
• Providers in Vestavia Hills, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.