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NPI Code Detail

MEDICARE: MRS. JACINTH EDNA BROOKS MD

MEDICARE: MRS. JACINTH EDNA BROOKS MD
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 PhysicianD40209MD

General Provider Information

NPI Number : 1225117211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACINTH EDNA BROOKS MD
Provider Business Mailing Address
First Line : 6230 OLD DOBBIN LN STE 230
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-5884
Country : US
Telephone Number : 410-730-3399
Fax Number :
Provider Business Practice Location Address
First Line : 6250 OLD DOBBIN LN
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-5816
Country : US
Telephone Number : 410-730-3399
Fax Number : 443-478-4736
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 10/21/2024

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