James Dean Vanbrocklin, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Burt, MI
NPI 1679877369 · NPPES record last updated Sep 27, 2016
Key facts
- NPI
- 1679877369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 4301024280 (MI)
- Practice address
- 2040 E Burt Rd
Burt, MI 48417-9459 - Phone
- (520) 241-3522
- NPI assigned
- Jan 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301024280 | MI | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 4301024280 | MI | Yes |
Addresses
Primary practice location
2040 E Burt Rd
Burt, MI 48417-9459
Mailing address
36959 S Ribbonwood LN
Tucson, AZ 85739-1210
Phone (520) 818-1925
Other providers in Burt, MI
- Elliott & Associates Counseling Services, LLC
- Bsma Hallam
- Mary Joe Ray Kinney
- Sarah B Moore
- Aubrey F Odell
All providers in Burt, MI · Physical Medicine & Rehabilitation Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2016. 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.