Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 9920 | SC |
N | 207R00000X | Internist | 9920 | SC |
N | 111NI0900X | Internist | 9920 | SC |
NPI | 1659440964 |
---|---|
Provider Name | Dr. John Herbert Brooks |
First Address | Spartanburg, SC 29307 |
Second Address | Spartanburg, SC 29307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |