Provider Demographics
NPI:1275531725
Name:ROCK, DOUGLAS BRENT (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BRENT
Last Name:ROCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:751 HORIZON CT
Mailing Address - Street 2:SUITE 259
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8733
Mailing Address - Country:US
Mailing Address - Phone:970-257-1786
Mailing Address - Fax:970-257-0035
Practice Address - Street 1:750 WELLINGTON AVE
Practice Address - Street 2:ST. MARY'S MEDICAL PAVILION, RADIATION ONCOLOGY
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6132
Practice Address - Country:US
Practice Address - Phone:970-244-2442
Practice Address - Fax:970-244-7008
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-07-02
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Provider Licenses
StateLicense IDTaxonomies
CO365472085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1365477Medicaid
CO841340905003OtherROCKY MOUNTAIN
G65655Medicare UPIN
CO1365477Medicaid