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DR. JACK A BROCK M.D.
NPI 1851395610
Radiology - Diagnostic Radiology in Albuquerque, NM

Active since June 09, 2005
4411 THE 25 WAY NE, STE 150, ALBUQUERQUE, NM 87109(505) 332-6900(505) 332-6921 Get Directions Write a Review

NPPES record last updated: October 18, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack A Brock M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK A BROCK M.D. (NPI 1851395610) is an individual diagnostic radiology provider in Albuquerque, New Mexico, licensed in New Mexico (77-139) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1851395610
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. JACK A BROCKCredential: M.D.
Location Address4411 THE 25 WAY NE, STE 150Albuquerque, NM 87109-5888
Mailing Address4411 The 25 Way Ne, Ste 150Albuquerque, NM 87109-5888 · (505) 332-6900 · Fax (505) 332-6921
Phone(505) 332-6900
Fax(505) 332-6921
Sole ProprietorNo
Enumeration DateJune 9, 2005
Last NPPES UpdateOctober 18, 2007
✔ NPI 1851395610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in NM · 77-139
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
4411 THE 25 WAY NE, Albuquerque, NM 87109
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Other Identifiers 7

Other2258272NM · Medicare Group
Medicaid45138NM
Medicare PIN3RADIA002NM
MedicaidL0634NM
Medicare UPINE74960NM
Medicaid52713NM
Medicaid22467NM

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENDA LYNN MORGAN NP
Nurse Practitioner (Psychiatric/Mental Health)
4411 THE 25 WAY NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 816-3994
DR. LUIS CENTENERA MD
Radiology (Diagnostic Radiology)
4411 THE 25 WAY NE, SUITE 150
ALBUQUERQUE, NM 87109
Bernalillo County (505) 332-5800
SHANNON G STARR LMSW
Social Worker
4411 THE 25 WAY NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 702-9970
GLENN S. ROUSH M.D.
Radiology (Diagnostic Radiology)
4411 THE 25 WAY NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 332-6921
DR. JUAN CARLOS MENA MD
Radiology (Diagnostic Radiology)
4411 THE 25 WAY NE, SUITE 150
ALBUQUERQUE, NM 87109
Bernalillo County (505) 332-6900
KATHLEEN MARIE LOPEZ MD
Radiology (Diagnostic Radiology)
4411 THE 25 WAY NE, SUITE 150
ALBUQUERQUE, NM 87109
Bernalillo County (505) 332-6900
DR. RENEE J BUTLER-LEWIS M.D.
Radiology (Diagnostic Radiology)
4411 THE 25 WAY NE, STE 150
ALBUQUERQUE, NM 87109
Bernalillo County (505) 332-6900
DANIEL A FUENTES-BERNARDO MD
Radiology (Diagnostic Radiology)
4411 THE 25 WAY NE, SUITE 150
ALBUQUERQUE, NM 87109
Bernalillo County (505) 332-6900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Brock's NPI number?

The NPI number for Jack Brock is 1851395610. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Jack Brock located?

Jack Brock practices at 4411 The 25 Way NE Ste 150, Albuquerque, NM 87109. The listed phone number is (505) 332-6900.

What is Jack Brock's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Jack Brock was last updated on October 18, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.