Provider Demographics
NPI:1205197068
Name:KAPLAN, BROOKE SCHAEFFER (OD)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:SCHAEFFER
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-6102
Mailing Address - Country:US
Mailing Address - Phone:205-661-2080
Mailing Address - Fax:205-661-2085
Practice Address - Street 1:2737 HIGHWAY 280 S
Practice Address - Street 2:SUITE 191
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2466
Practice Address - Country:US
Practice Address - Phone:205-802-2020
Practice Address - Fax:205-803-0078
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C84152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist