Provider Demographics
NPI:1093990277
Name:BROOKS, PATRICIA JO (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JO
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JO
Other - Last Name:WOLKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3401 W 49TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2322
Mailing Address - Country:US
Mailing Address - Phone:605-328-1850
Mailing Address - Fax:605-328-1855
Practice Address - Street 1:3401 W 49TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2322
Practice Address - Country:US
Practice Address - Phone:605-328-1850
Practice Address - Fax:605-328-1855
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine