Provider Demographics
NPI:1275573420
Name:BROOKS, ALICE JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:JOYCE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
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 7003
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29021-7003
Mailing Address - Country:US
Mailing Address - Phone:803-424-5780
Mailing Address - Fax:803-424-5795
Practice Address - Street 1:1315 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-3737
Practice Address - Country:US
Practice Address - Phone:803-424-5780
Practice Address - Fax:803-424-5795
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC140083Medicaid
SC140083Medicaid