MR. DAVID WESLEY BROCK (NPI# 1205024122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205024122 |
| Entity Type | Individual |
| Full Name | MR. DAVID WESLEY BROCK |
| Credential | PA-C |
| Practice Address |
3550 N University Ave Suite 250 Provo UT 84604-6683 |
| Mailing Address |
100 N Mario Capecchi Dr Suite 250 Salt Lake City UT 84113-1103 |
| Practice Telephone | 8013749625 |
| Practice Fax Number | 8013749690 |
| Mailing Telephone | 8016625582 |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2016-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
6725565-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427575224 | David Brock | Specialist/Technologist | 106 E Main St., Spring Arbor, MI 49283 | 2017-08-23 |
| 1578926259 | David B Brock | Occupational Therapist | 220 N Main Ave, Scranton, PA 18504-3304 | 2016-03-31 |
| 1912159351 | David J Brock | Social Worker | 1020 Long Blvd, 5, Lansing, MI 48911-6896 | 2008-10-16 |
| 1881756278 | David Phillip Brock | Dentist | 40 Dormody Ct, Suite A, Monterey, CA 93940-2908 | 2006-12-14 |
| 1225009392 | David Todd Brock | Family Medicine | 2656 Sw 118th Ter, Gainesville, FL 32608 | 2006-01-27 |
| 1568589752 | David Whitfield Brock | Internal Medicine | 1155 Mill St, Reno, NV 89502 | 2007-03-23 |
| 1447273057 | David G. Brock | Psychiatry & Neurology | 900 Walnut St, 2nd Floor, Philadelphia, PA 19107-5509 | 2006-07-25 |
| 1124040423 | David F Brock | Physical Therapist | 26617 Carmel Center Pl, Carmel, CA 93923-8655 | 2006-07-24 |
| 1699716795 | David H Brock | Counselor | 4325 Laurel St, Anchorage, AK 99508-5338 | 2006-06-09 |
| 1275599250 | David L. Brock | Dentist | 1600 Sw Archer Rd, D4-4, Gainesville, FL 32610-3003 | 2006-04-26 |
| Street Address |
3550 N UNIVERSITY AVE SUITE 250 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-6683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851347090 | Craig S Cook | Surgery | 3550 N University Ave, Ste 250, Provo, UT 84604 | 2006-05-26 |
| 1336697473 | Rachel Oswald Freeman | Nurse Practitioner | 3550 N University Ave, #250, Provo, UT 84604-6683 | 2016-09-19 |
| 1851521249 | David L Peterson | Physician Assistant | 3550 N University Ave, Ste 250, Provo, UT 84604-6683 | 2009-07-20 |
| 1083869101 | Christy Anderson | Nurse Practitioner | 3550 N University Ave, Ste 250, Provo, UT 84604-6683 | 2008-11-18 |
| 1841470879 | Cindy Evans | Nurse Practitioner | 3550 N University Ave, Sutie #250, Provo, UT 84604-6683 | 2007-11-07 |
| 1700932068 | David Michael Watts | Surgery | 3550 N University Ave, Suite 250, Provo, UT 84604-6683 | 2007-01-26 |
| 1568497634 | Jennifer J Tittensor | Surgery | 3550 N University Ave, Ste 250, Provo, UT 84604 | 2006-07-11 |
| 1316987613 | Lee M Peterson | Surgery | 3550 N University Ave, Suite 250, Provo, UT 84604 | 2006-06-07 |
| 1215977517 | Richard M Thomas | Surgery | 3550 N University Ave, Suite #250, Provo, UT 84604 | 2006-06-07 |
| 1699715664 | Bruce B Hill | Surgery | 3550 N University Ave, Suite 250, Provo, UT 84604 | 2006-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164666061 | Stephen A Loper | Physician Assistant | 1055 N 500 W Ste 211, Provo, UT 84604-3305 | 2009-04-23 |
| 1255517488 | William R. Mathie | Physician Assistant | 1055 N 500 W Ste 121, Provo, UT 84604-3305 | 2008-01-17 |
| 1023352952 | Joan Margaret Butler | Physician Assistant | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2012-11-15 |
| 1588928097 | Brady Charles Norton | Physician Assistant | 1055 N 500 W, Provo, UT 84604-3305 | 2012-06-28 |
| 1184984320 | Daniel Christensen | Physician Assistant | 1055 N 500 W Ste 207, Provo, UT 84604-3305 | 2012-05-22 |
| 1184930786 | Drew Kenner Lambourne | Physician Assistant | 1055 N 500 W, Suite 121, Provo, UT 84604-3305 | 2010-08-20 |
| 1851625255 | Jami Z Mckell | Physician Assistant | 1034 N 500 W, Provo, UT 84604-3380 | 2009-10-01 |
| 1730318445 | Stephen Cruze | Physician Assistant | 1055 N 500 W, Suite 121, Provo, UT 84604-3305 | 2009-07-02 |
| 1255371878 | Adam C Phillips | Physician Assistant | 1034 N 500 W, Provo, UT 84604-3380 | 2006-06-08 |
| 1104801315 | Scott Alan Lange | Physician Assistant | 1134 N 500 W, Suite 100, Provo, UT 84604-3383 | 2005-12-09 |
| Find all providers in PROVO | ||||
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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.