Provider Demographics
NPI:1275581498
Name:BROOKS MEDICAL ARTS, INC
Entity Type:Organization
Organization Name:BROOKS MEDICAL ARTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-744-8525
Mailing Address - Street 1:180 GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1645
Mailing Address - Country:US
Mailing Address - Phone:814-744-8525
Mailing Address - Fax:814-744-9291
Practice Address - Street 1:180 GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1645
Practice Address - Country:US
Practice Address - Phone:814-744-8525
Practice Address - Fax:814-744-9291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006336680001Medicaid
PA0006336680001Medicaid