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Next Update: Thursday, December 19, 2024 12:00 PM CST

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BROCK, JACK ARTHUR       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 4411 THE 25 WAY NE
SUITE 150
ALBUQUERQUE NM 87109

Address last updated on 6/9/2003
Phone #: (505) 332-6900
Fax #:
County: NOT OKLAHOMA
License: 9917
Dated: 4/20/1973
Expires: 4/1/2006
License Type: Medical Doctor
Specialty: Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Washington Univ in St Louis Sch of Med, St Louis MO
Graduated: / 1968
CME Year: 2007
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF RADIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
4411 THE 25 WAY NE
SUITE 150
ALBUQUERQUE NM 87109

Phone #: (505) 332-6900
Fax #:

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