Provider Demographics
NPI:1003292723
Name:BROOKS, JAMES STEVEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-1511
Mailing Address - Country:US
Mailing Address - Phone:229-524-2596
Mailing Address - Fax:229-524-2631
Practice Address - Street 1:409 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1511
Practice Address - Country:US
Practice Address - Phone:229-524-2596
Practice Address - Fax:229-524-2631
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017200183500000X
FLPS29249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist