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General NPI Number Information
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NPI Number | 1699100164
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Entity Type | Organization
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Legal Business Name | THE BROOKS ACCIDENT AND INJURY CLINIC, LLC
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 820 NW 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-6827
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Country | US
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Telephone | 405-943-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 820 NW 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-6827
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Country | US
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Telephone | 405-943-0303
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RODNEY MILLER
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Credential |
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Telephone | 405-943-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 20823
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1432
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2502
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License Number State | OK
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