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NPI Code Detail

MEDICARE: DR. JOSEPH C BROOME MD

MEDICARE: DR. JOSEPH C BROOME 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
1207Q00000XFamily Medicine Physician23006OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123006OTHEROKSTATE MEDICAL LICENSE

General Provider Information

NPI Number : 1306817887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH C BROOME MD
Provider Business Mailing Address
First Line : 7530 NW 23RD ST
Second Line :
City : BETHANY
State : OK
Zip : 73008-4942
Country : US
Telephone Number : 405-787-4915
Fax Number : 405-789-6303
Provider Business Practice Location Address
First Line : 7530 NW 23RD ST
Second Line :
City : BETHANY
State : OK
Zip : 73008-4921
Country : US
Telephone Number : 405-787-4915
Fax Number : 405-789-6303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 07/21/2022

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Directions to “ DR. JOSEPH C BROOME MD” Practice Location

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