Brookhaven Medical Center, PLLC
Organization Active NPI Family Medicine Physician · Cleveland, MS
NPI 1821033341 · NPPES record last updated Jul 5, 2010
Key facts
- NPI
- 1821033341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 17310 (MS)
- Legal business name
- BROOKHAVEN MEDICAL CENTER, PLLC
- Practice address
- 218 S Victoria Ave
Cleveland, MS 38732-3234 - Phone
- (901) 217-3480
- NPI assigned
- Jun 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Deborah Michelle Brooks, M.D.
- Title
- C.E.O.
- Phone
- (901) 217-3480
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 17310 | MS | Yes |
Addresses
Primary practice location
218 S Victoria Ave
Cleveland, MS 38732-3234
Mailing address
218 S Victoria Ave
Cleveland, MS 38732-3234
Phone (901) 217-3480
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00124352 | Medicaid | MS |
Other providers in Cleveland, MS
- Mari Jane Bosworth
- Mari Micci Bramuchi
- Michael Braswell
- Nohemie Brevil
- Charles E Brock Jr.
- Amberly Brown
- Celeste Brown
- Hamilton Brown
- Nate Brown
- Matthew Reed Buckley
All providers in Cleveland, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 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.