Brooks, Douglas A
Brooks, Douglas A is an individual health care provider with primary practice located at 2702 Cunningham Ave Ste A, Joplin MO 64804-1570. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Brooks, Douglas A can be contacted via phone (417) 782-1910.Contact Information
Primary practice address
2702 Cunningham Ave Ste A
Joplin MO 64804-1570
Phone: (417) 782-1910
Fax: (417) 782-1844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 00218 | Missouri |
Profile Details
| NPI number | 1043201221 |
|---|---|
| LBN Legal business name | Brooks, Douglas A |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Apr 11th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043201221 | NPPES |
| Missouri | MEDICAID | 493312300 | |
| Missouri | MEDICAID | 100240090B |
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