MEDICARE: DR. WILLIAM R BROOKE MEDICAL DOCTOR

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	00009384	AL

General Provider Information

NPI Number	:	1477541548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM R BROOKE MEDICAL DOCTOR

Provider Business Mailing Address
First Line	:	109 4TH AVENUE NW
Second Line	:
City	:	ALICEVILLE
State	:	AL
Zip	:	35442
Country	:	US
Telephone Number	:	205-373-3945
Fax Number	:	205-373-3386

Provider Business Practice Location Address
First Line	:	1700 HOLT RD NE
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35404-1046
Country	:	US
Telephone Number	:	205-562-1241
Fax Number	:	205-562-1741

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	03/04/2026

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