Brooks, Simon Roland
Brooks, Simon Roland is an individual health care provider with primary practice located at 4300 W Main St Suite 102, Dothan AL 36305-1054. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Brooks, Simon Roland can be contacted via phone (334) 793-9564.Contact Information
Primary practice address
4300 W Main St Suite 102
Dothan AL 36305-1054
Phone: (334) 793-9564
Fax: (334) 671-8907
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 12707 | Alabama |
Profile Details
NPI number | 1588658033 |
---|---|
LBN Legal business name | Brooks, Simon Roland |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 9th, 2005 |
Last updated | Dec 6th, 2007 - about 17 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 | 1588658033 | NPPES |
Georgia | MEDICAID | 00455672A |
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