WADE DALE BROCK (NPI# 1609885805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609885805 |
Entity Type | Individual |
Full Name | WADE DALE BROCK |
Credential | MD |
Practice Address |
9800 Baptist Health Dr Ste 500 Little Rock AR 72205-6243 |
Mailing Address |
9800 Lile Dr Suite 500 Little Rock AR 72205-6229 |
Practice Telephone | 5012232244 |
Practice Fax Number | 5012232231 |
Mailing Telephone | 5012232244 |
Mailing Fax Number | 5012232231 |
Enumeration Date | 2006-08-05 |
Last Update Date | 2017-12-13 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
E2380 | AR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 154129001 | 05 | |
AR | RAILROAD MEDICARE | DE6376 | 01 |
Street Address |
9800 BAPTIST HEALTH DR STE 500 |
City | LITTLE ROCK |
State | AR |
Zip Code | 72205-6243 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396852901 | Arkansas Oculoplastic Surgery, Pllc | Ophthalmology | 9800 Baptist Health Dr Ste 500, Little Rock, AR 72205-6243 | 2006-08-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
Find all providers in zip 72205 |
Taxonomy Code | 207WX0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
Specialization | Ophthalmic Plastic and Reconstructive Surgery |
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912906876 | Jennifer Trew Scruggs | Ophthalmology | 9800 Baptist Health Dr, Suite 600, Little Rock, AR 72205-6229 | 2005-07-21 |
1396852901 | Arkansas Oculoplastic Surgery, Pllc | Ophthalmology | 9800 Baptist Health Dr Ste 500, Little Rock, AR 72205-6243 | 2006-08-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093338030 | Natural State Aesthetics Pllc | Ophthalmology | 613 N Willow Ave, Fayetteville, AR 72701-3550 | 2020-05-26 |
City | LITTLE ROCK |
Zip Code | 72205 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.