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General NPI Number Information
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NPI Number | 1932316890
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Entity Type | Organization
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Legal Business Name | ROBERT F. BROOKS, O.D., P.S.C.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 1621 ASHLAND RD UNIT 3
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City | GREENUP
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State | KY
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Zip | 41144-1207
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Country | US
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Telephone | 606-473-5322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 723
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City | GREENUP
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State | KY
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Zip | 41144-0723
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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 | OWNER
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Name | DR. RICHARD BRADLEY MORRIS
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Credential | O.D.
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Telephone | 606-473-5322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 1643DT
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1643DT
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License Number State | KY
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