JAY DAVID BROCK MD PC NPI 1053359968

NPI Information

  • NPI: 1053359968
  • Provider Name: JAY DAVID BROCK, MD, PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 4304 LAFAYETTE BLVD
    FREDERICKSBURG, VA
    ZIP 22408
  • Phone: (540) 891-5600

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NPI Details

JAY DAVID BROCK, MD, PC is a family medicine in Fredericksburg, VA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JAY DAVID BROCK, MD, PC NPI is 1053359968. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4304 LAFAYETTE BLVD
FREDERICKSBURG, VA
ZIP 22408-234
Phone: (540) 891-5600
Fax: (540) 891-9034

The provider's authorized official is Jay D. Brock .
The authorized official title is Physician and has the following contact phone number (540) 891-5600.

The enumeration date for this NPI number is 6/3/2006 and was last updated on 5/3/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine0101032059VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15690803MEDICAIDVIRGINIA
2081953178MEDICARE PINVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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