JONATHAN RUSSELL BROCK

MACON, GA
NPI1871927269
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology
(Licence: GA  102044)
Additional Taxonomies207R00000X Internal Medicine
(Licence: NC  2022-00009)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2013-08-21
Last Update Date2025-08-19
Business Address
JONATHAN RUSSELL BROCK M.D.
1062 FORSYTH ST STE 1B
MACON, GA 31201-8638
Phone number: 478-741-1208
Mailing Address
JONATHAN RUSSELL BROCK M.D.
1062 FORSYTH ST STE 1B
MACON, GA 31201-8638
Phone number: 478-741-1208