Larry Dale Brock, M.D

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

5347 Issued in AL

Practice address

5901 Airport Blvd
Suite E
Mobile, AL 36608-3169

Phone

(251) 342-0505

Fax

(251) 342-0360

NPI assigned

May 30, 2007

Last updated

Nov 21, 2008By 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 2

Addresses

Other names 1

• Dr. Larry Dale Brock Professional name

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227225600000",
    "number": "1730380502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 FAIRFAX RD S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082938",
            "telephone_number": "251-343-1598",
            "fax_number": "251-342-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 AIRPORT BLVD",
            "address_2": "SUITE E",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083169",
            "telephone_number": "251-342-0505",
            "fax_number": "251-342-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "LARRY",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "5347",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "AL",
            "license": "5347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "BROCK",
            "middle_name": "DALE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alexandra J Brock
• Benjamin Brock, PA
• Berkley Laurel Brock
• Cameron Leighton Brock, PA-S
• Catherine Wesson Brock, O.T.R./L
• Harmony Rae Brogden, PA
• Kayla Brooke
• Margaret Maryanna Brooke, PHARM.D.
• Bradley Brooks, D.O.
• Brianna Brooks

• Public Health & General Preventive Medicine Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Public Health & General Preventive Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.