MEDICARE: WILLIAM JAMES BROOKS, DO, PC.

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician

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	:	1740823103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM JAMES BROOKS, DO, PC.

Provider Business Mailing Address
First Line	:	5363 E PIMA ST STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3663
Country	:	US
Telephone Number	:	816-746-0128
Fax Number	:	520-269-6339

Provider Business Practice Location Address
First Line	:	5281 N VIA SEMPREVERDE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-5968
Country	:	US
Telephone Number	:	816-746-0128
Fax Number	:	877-794-8238

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM J BROOKS
Credential	:	DO
Telephone Number	:	816-746-0128

Provider Enumeration Date	:	10/17/2019
Last Update Date	:	09/25/2022

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