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General NPI Number Information
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NPI Number | 1790791838
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Entity Type | Individual
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Provider Name | ROBERT A BROOKS PA
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 605 N WESTOVER BLVD
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City | ALBANY
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State | GA
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Zip | 31707-2188
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Country | US
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Telephone | 229-434-4200
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Fax | 229-434-4208
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Provider Business Mailing Address
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Address Line | 605 N WESTOVER BLVD
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City | ALBANY
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State | GA
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Zip | 31707-2188
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Country | US
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Telephone | 229-434-4200
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Fax | 229-434-4208
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 004802
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License Number State | GA
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