MEDICARE: BARRY BROOK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35053582B	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00856773	OTHER	OH	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215993779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY BROOK MD

Provider Business Mailing Address
First Line	:	4750 E GALBRAITH RD STE 111
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-6706
Country	:	US
Telephone Number	:	513-686-4840
Fax Number	:	513-686-4848

Provider Business Practice Location Address
First Line	:	4750 E GALBRAITH RD STE 111
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-6706
Country	:	US
Telephone Number	:	513-686-4840
Fax Number	:	513-686-4848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	01/23/2020

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Directions to “ BARRY BROOK MD” Practice Location

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