MEDICARE: STUART G BROOKER 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	207L00000X	Anesthesiology Physician	036929	GA
2	207L00000X	Anesthesiology Physician	36929	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1356378616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART G BROOKER MD

Provider Business Mailing Address
First Line	:	2805 N HILLS DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-3209
Country	:	US
Telephone Number	:	404-841-0413
Fax Number	:

Provider Business Practice Location Address
First Line	:	69 JESSE HILL JR DR SE
Second Line	:	DEPT OF ANESTHESIOLOGY
City	:	ATLANTA
State	:	GA
Zip	:	30303-3033
Country	:	US
Telephone Number	:	404-778-4852
Fax Number	:

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	05/06/2024

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Directions to “ STUART G BROOKER MD” Practice Location

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