Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | D0051017 | MD |
Y | 207VX0201X | Gynecologic Oncologist | D0051017 | MD |
NPI | 1013944750 |
---|---|
Provider Name | Dr. Sandra E Brooks |
First Address | Louisville, KY 40202-1703 |
Second Address | Louisville, KY 40207-4729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 27/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E50284 | (02) | MD |