Brooks, Blake Jay

Brooks, Blake Jay is an individual health care provider with primary practice located at 1205 W Broadway , Columbia MO 65203-2125. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Brooks, Blake Jay can be contacted via phone (573) 499-0642.

Contact Information

Primary practice address
1205 W Broadway Columbia MO 65203-2125
Phone: (573) 499-0642
Fax: (573) 449-1787
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 119892 Missouri

Profile Details

NPI number 1255337390
LBN Legal business name Brooks, Blake Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Oct 5th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255337390 NPPES
Missouri Other 1963097 FIRST HEALTH
Missouri Other 42482 FIRST HEALTH
Missouri Other H51820 FIRST HEALTH
Missouri Other 539285 FIRST HEALTH
Missouri Other 431535214 FIRST HEALTH
Missouri Other 000623655 FIRST HEALTH
Missouri Other 143480 FIRST HEALTH
Missouri MEDICAID 208373407 FIRST HEALTH
Missouri Other 3100264 FIRST HEALTH
Missouri Other P01764602 FIRST HEALTH
Missouri Other 110245813 FIRST HEALTH
Missouri Other 178793 FIRST HEALTH
Missouri Other 7359531 FIRST HEALTH

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