Broome, Dean Carl

Broome, Dean Carl is an sole proprietor health care provider with primary practice located at 115 Main St , Blackshear GA 31516-0271. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatric Endocrinology, Allopathic & Osteopathic Physicians / Legal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Broome, Dean Carl can be contacted via phone (912) 449-1477.

Contact Information

Primary practice address
115 Main St Blackshear GA 31516-0271
Phone: (912) 449-1477
Fax: (912) 449-1479
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 048604 Georgia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 048604 Georgia
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 048604 Georgia
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 048604 Georgia
Allopathic & Osteopathic Physicians / Legal Medicine 209800000X 048604 Georgia

Profile Details

NPI number 1356548002
LBN Legal business name Broome, Dean Carl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2007
Last updated Jul 8th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356548002 NPPES
Georgia MEDICAID 00886872A

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