Paul Jeffrey Brooks
Oral and Maxillofacial Surgeon
2140 Lake Michigan Dr Nw
Grand Rapids
, Michigan 49504-4785
Paul Jeffrey Brooks
Oral and Maxillofacial Surgeon
2140 Lake Michigan Dr Nw
Grand Rapids
, Michigan 49504-4785
(616) 735-2871
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Paul Jeffrey Brooks
- 2140 Lake Michigan Dr Nw
- Grand Rapids, MI
- Zip : 49504-4785
- Fax : (616) 735-2871
- Phone : (616) 735-2870
Second Address
- Paul Jeffrey Brooks
- 2140 Lake Michigan Dr Nw
- Grand Rapids, MI
- Zip : 49504-4785
- Fax : (616) 735-2871
- Phone : (616) 735-2870
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2901016571 | MI |
National Provider Identifier
| NPI | 1053406728 |
|---|---|
| Provider Name | Paul Jeffrey Brooks |
| First Address | Grand Rapids, MI 49504-4785 |
| Second Address | Grand Rapids, MI 49504-4785 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0D111530 | BCBSM (01) | MI |
| 165710 | BCBSD (01) | MI |
| U79067 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.