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General NPI Number Information
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NPI Number | 1235775370
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Entity Type | Individual
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Provider Name | TOMMY BROOKS HIS
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Gender | Male
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 6375 U S HIGHWAY 98 STE 45
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City | HATTIESBURG
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State | MS
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Zip | 39402-7411
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Country | US
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Telephone | 601-261-5923
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Fax | 304-726-3313
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Provider Business Mailing Address
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Address Line | 5750 JOHNSTON ST STE 502
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City | LAFAYETTE
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State | LA
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Zip | 70503-5334
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Country | US
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Telephone | 337-294-8081
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Fax | 337-335-0015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA0681
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License Number State | MS
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