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General NPI Number Information
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NPI Number | 1386175800
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Entity Type | Organization
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Legal Business Name | JAMES S. BROOKS, MD, PLLC
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Dates
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Enumeration Date | 03/26/2017
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 29275 NORTHWESTERN HWY STE 208
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City | SOUTHFIELD
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State | MI
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Zip | 48034-5744
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Country | US
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Telephone | 248-356-7772
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Fax | 248-356-7779
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Provider Business Mailing Address
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Address Line | 29275 NORTHWESTERN HWY STE 208
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City | SOUTHFIELD
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State | MI
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Zip | 48034-5744
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JAMES S BROOKS
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Credential | MD
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Telephone | 248-356-7772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301403985
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License Number State | MI
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