Provider Demographics
NPI:1699161398
Name:WARFORD, BROCK ALDEN (MD)
Entity type:Individual
Prefix:
First Name:BROCK
Middle Name:ALDEN
Last Name:WARFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-609-2229
Mailing Address - Fax:
Practice Address - Street 1:118 WOMENS CENTER LN
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6352
Practice Address - Country:US
Practice Address - Phone:501-609-2229
Practice Address - Fax:501-609-2342
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-12370207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program