E Dale Brock (NPI# 1538161708, PAC ID# 0143306746) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1538161708 |
| PAC ID by PECOS | 0143306746 |
| Professional Enrollment ID | I20080324000412 |
| Full Name | E Dale Brock |
| Organization Legal Name | E DALE BROCK OD PC |
| Address |
202 E Clark St West Frankfort IL 62896-2706 |
| Phone Number | 6189373126 |
| Gender | M |
| Medical School | SOUTHERN COLLEGE OF OPTOMETRY |
| Graduation Year | 1976 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 9739266925 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 202 E Clark St, West Frankfort, IL 62896-2706 | 6189373126 | E DALE BROCK OD PC |
| Organization Legal Name | E DALE BROCK OD PC |
| Physicians | 1 |
| Street Address |
202 E CLARK ST |
| City | WEST FRANKFORT |
| State | IL |
| Zip | 62896-2706 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa L Myers | Optometry | 202 E Clark St, West Frankfort, IL 62896-2706 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robin Dailey | Nurse Practitioner | Southern Illinois Medical Care Associates LLC | 406 W Saint Louis St, West Frankfort, IL 62896-1956 |
| Danneille C Trujillo Hansen | Certified Clinical Nurse Specialist (cns) | 410 W Saint Louis St, West Frankfort, IL 62896-1956 | |
| Julie Adkins | Nurse Practitioner | 406 W Saint Louis St, West Frankfort, IL 62896-1956 | |
| Adam J Henson | Family Medicine | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Christopher S Shadowens | Physician Assistant | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Diana L Tomlianovich | Nurse Practitioner | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Wesley Ray Howell | Physician Assistant | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Meredith Grace Lukens | Physician Assistant | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Elizabeth A Parks | Physician Assistant | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Rachel Lynn Terrill | Physician Assistant | Southern Illinois Medical Services, Nfp | 502 W Saint Louis St, Suite 4, West Frankfort, IL 62896-1968 |
| Find all physicians in zip 62896 | |||
| City | WEST FRANKFORT |
| Zip Code | 62896 |
| Specialty | OPTOMETRY |
| City + Specialty | WEST FRANKFORT + OPTOMETRY |
Please comment or provide details below to improve the information on E Dale Brock.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.