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NPI Code Detail

MEDICARE: DR. TIMOTHY RAY BROOKS M.D.

MEDICARE: DR. TIMOTHY RAY BROOKS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician0101252343VA
2207Q00000XFamily Medicine Physician0101252343VA

General Provider Information

NPI Number : 1184919573
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY RAY BROOKS M.D.
Provider Business Mailing Address
First Line : USS KEARSARGE (LHD 3)
Second Line :
City : FPO
State : AE
Zip : 09534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1721 ADMIRAL TAUSSIG BLVD
Second Line :
City : NORFOLK
State : VA
Zip : 23511-2802
Country : US
Telephone Number : 757-953-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2011
Last Update Date : 10/12/2023

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