RONDAL KEITH BROCK (NPI# 1811075088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811075088 |
| Entity Type | Individual |
| Full Name | RONDAL KEITH BROCK |
| Credential | P.A.C. |
| Practice Address |
Tazewell Medical Clinic 1442 North Broad Street Suite 7 Tazewell TN 37879 |
| Mailing Address |
1037 Old Jacksoboro Road Cumberland Gap TN 37724-4444 |
| Practice Telephone | 4236266145 |
| Practice Fax Number | 4235262804 |
| Mailing Telephone | 4238699980 |
| Mailing Fax Number | 4235262804 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
TAZEWELL MEDICAL CLINIC 1442 NORTH BROAD STREET SUITE 7 |
| City | TAZEWELL |
| State | TN |
| Zip Code | 37879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689174211 | Heather Hunley | Nurse Practitioner | 951 N. Broad St, Tazewell Express Care, Tazewell, TN 37879 | 2018-02-20 |
| 1225540495 | Amy Howe | Nurse Practitioner | 1582 N Broad St Ste 2, Tazewell, TN 37879 | 2017-10-28 |
| 1497063903 | Minton Family Dental Care | Dentist | 210 Cedar Fork Rd., Tazewell, TN 37879 | 2010-09-17 |
| 1528259470 | Foster Chiropractic, P.C. | Chiropractor | 2255 Hwy 25e, Suite 2, Tazwell, TN 37879 | 2007-08-06 |
| 1922185644 | Tri State Sports Medicine and Rehabilitation Inc | Physical Therapist | 2255 Highway 25e Ste 4, Tazewell, TN 37879 | 2006-11-01 |
| 1407932387 | La Wanna Wallen Brock | Nurse Practitioner | 1442 North Broad Street, Suite 7, Tazewell, TN 37879 | 2006-10-31 |
| 1952493462 | Home Town Pharmacy Inc. | Pharmacy | 1410 N. Broadstreet, Tazewell, TN 37879 | 2006-09-29 |
| 1700892429 | Trail of The Cumberlands Anesthesia Associates | Nurse Anesthetist, Certified Registered | 1850 Old Knoxville Hwy, Claiborne County Hospital, Tazewell, TN 37879 | 2006-08-01 |
| 1598718587 | Rosemary Kay Hall | Chiropractor | 1450 Broad St, Suite 1, Tazewell, TN 37879 | 2006-05-18 |
| 1780652735 | Nancy Jean Day | Nurse Practitioner | 620 Davis Drive, Tazewell, TN 37879 | 2006-03-08 |
| Find all providers in zip 37879 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912371683 | Courtney Paige Brooks | Physician Assistant | 513 Orange St, Tazewell, VA 24651-9616 | 2015-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840972 | Alexis Sierra Foster | Physician Assistant | 953 Prince Ave, Erwin, TN 37650-1445 | 2020-11-01 |
| 1972110831 | Marleen Yosef | Physician Assistant | 6 Whitsett Rd, Nashville, TN 37210-5345 | 2020-09-24 |
| 1538772744 | Kaitlyn Blair Barger | Physician Assistant | 2100 Clinch Ave Ste 120, Knoxville, TN 37916-2288 | 2020-08-26 |
| 1225653967 | Molly Ann Waggoner | Physician Assistant | 9050 Executive Park Dr Ste 100b, Knoxville, TN 37923-4616 | 2020-06-09 |
| 1134749922 | Mckenzie Jacobson | Physician Assistant | 302 Tyson Ave # B, Paris, TN 38242-4576 | 2020-04-21 |
| 1316580913 | Donald Jacob Calella | Physician Assistant | 8146 Propeller Dr, Ooltewah, TN 37363-9561 | 2019-10-26 |
| 1811458565 | Physician Associate Resources, Plc | Physician Assistant | 1559 Highland Park Drive, Lenoir City, TN 37772 | 2019-03-26 |
| 1336617059 | Micaela L Goebel | Physician Assistant | 120 Tanner Pl Bldg H, Clinton, TN 37716-6684 | 2018-11-12 |
| 1700369162 | Lauren Peyton Hunley | Physician Assistant | 6890 W Andrew Johnson Hwy, Talbott, TN 37877-8610 | 2018-09-12 |
| 1275039471 | Jessica Taylor Epting | Physician Assistant | 107 Glen Oak Blvd Ste 200, Hendersonville, TN 37075-3162 | 2018-04-05 |
| Find all providers with the same taxonomy | ||||
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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.