Brooks, David Wayne

Brooks, David Wayne is an individual health care provider with primary practice located at 1933 E Brent Ln , Fayetteville AR 72703-3154. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Brooks, David Wayne can be contacted via phone (479) 442-4614.

Contact Information

Primary practice address
1933 E Brent Ln Fayetteville AR 72703-3154
Phone: (479) 442-4614
Fax: (479) 442-2707
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X C7666 Arkansas

Profile Details

NPI number 1790861052
LBN Legal business name Brooks, David Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2006
Last updated Nov 19th, 2012 - about 13 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 1790861052 NPPES
Arkansas MEDICAID 117483001

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