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General NPI Number Information
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NPI Number | 1639280274
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Entity Type | Organization
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Legal Business Name | BROOKS EYE CENTER INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 3545 BLUECUTT RD
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City | COLUMBUS
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State | MS
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Zip | 39705-1324
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Country | US
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Telephone | 662-327-2020
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Fax | 662-327-6222
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Provider Business Mailing Address
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Address Line | 3545 BLUECUTT RD
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City | COLUMBUS
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State | MS
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Zip | 39705-1324
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Country | US
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Telephone | 662-327-2020
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Fax | 662-327-6222
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Authorized Official
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Title or Position | OWNER
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Name | JAMES E BROOKS
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Credential | OD
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Telephone | 662-327-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 455
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License Number State | MS
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