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Dr. Jack A Brock, MD
Diagnostic Radiology Physician in Albuquerque, New Mexico
NPI 1851395610

Jack A Brock is a Diagnostic Radiology Physician based in Albuquerque, NM and is specialized in Diagnostic Radiology. Jack A Brock practices in Albuquerque, NM and has the professional credentials of MD. The NPI Number for Jack A Brock is 1851395610 and holds a License No. 77-139 (New Mexico).

The current practice location address for Jack A Brock is 4411 The 25 Way Ne, Albuquerque, NM and can be reached out via phone at 505-332-6900 and via fax at 505-332-6921. You can also correspond with Jack A Brock through the mailing address at 4411 THE 25 WAY NE, ALBUQUERQUE, NM - 87109-5888 (mailing address contact number: 505-332-6900).

Location: 4411 The 25 Way Ne, Albuquerque, NM, 87109-5888
person
Provider Profile Details
NPI Number
1851395610
Provider Name
Jack A Brock
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4411 The 25 Way Ne, Albuquerque, NM, 87109-5888
Phone Number
505-332-6900
Fax Number
505-332-6921
Provider Enumeration Date
06/09/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
L0634 05 NM
52713 05 NM
22467 05 NM
45138 05 NM
2258272 01 NM MEDICARE GROUP
institution
Provider Business Practice Location Address Details
Address
4411 The 25 Way Ne
City
State
Zip
87109-5888
Phone Number
505-332-6900
Fax Number
505-332-6921
person
Provider Business Mailing Address Details
Address
4411 The 25 Way Ne
City
State
Zip
87109-5888
Phone Number
505-332-6900
Fax Number
505-332-6921
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
77-139 (New Mexico)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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