Healthcare Provider Details
I. General information
NPI: 1063527919
Provider Name (Legal Business Name): TRACY BROOKINGS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/20/2006
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4730 BELL HILL RD
BESSEMER AL
35022-6947
US
IV. Provider business mailing address
4730 BELL HILL RD
BESSEMER AL
35022-6947
US
V. Phone/Fax
- Phone: 205-426-3010
- Fax: 205-481-9034
- Phone: 205-426-3010
- Fax: 205-481-9034
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 26653 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: