Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 952 | AZ |
NPI | 1326120155 |
---|---|
Provider Name | Dr. Robert Thomas Brook |
First Address | Tucson, AZ 85710-2117 |
Second Address | Tucson, AZ 85710-2117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 24/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T76767 | (02) | AZ |