Provider Demographics
NPI:1326039330
Name:BROOKS, WALTER SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:SCOTT
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1620
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2209
Mailing Address - Country:US
Mailing Address - Phone:404-885-7701
Mailing Address - Fax:404-885-7777
Practice Address - Street 1:35 COLLIER RD NW
Practice Address - Street 2:SUITE 535
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1613
Practice Address - Country:US
Practice Address - Phone:404-351-9512
Practice Address - Fax:404-351-9815
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-01-14
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Provider Licenses
StateLicense IDTaxonomies
GA12101207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00058165EMedicaid
GA00058165EMedicaid
GAD44927Medicare UPIN