Herbert E Brooks MD PA
Organization Active NPI Legal Medicine · Bonifay, FL
NPI 1598091100 · NPPES record last updated Jan 8, 2010
Key facts
- NPI
- 1598091100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Legal Medicine 173000000X
- License
- ME11075 (FL)
- Legal business name
- HERBERT E BROOKS MD PA
- Practice address
- 2126 Highway 173
Bonifay, FL 32425-5704 - Phone
- (850) 547-4556
- Fax
- (850) 547-4511
- NPI assigned
- Nov 2, 2009
- Organization subpart
- No
Authorized official
- Name
- Herbert Edwin Brooks, MD
- Title
- Owner
- Phone
- (850) 547-4793
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine |
173000000X | ME11075 | FL | Yes |
Addresses
Primary practice location
2126 Highway 173
Bonifay, FL 32425-5704
Mailing address
PO Box 699
Bonifay, FL 32425-0699
Phone (850) 547-4556
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME0011075 | Other | FL | WC |
| 30009 | Other | FL | BCBS |
| 043250400 | Medicaid | FL |
Other providers in Bonifay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.