Provider Demographics
NPI:1326899600
Name:STROUD, BROOKS ASHMORE (MD)
Entity Type:Individual
Prefix:DR
First Name:BROOKS
Middle Name:ASHMORE
Last Name:STROUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-5704
Mailing Address - Country:US
Mailing Address - Phone:478-318-5149
Mailing Address - Fax:
Practice Address - Street 1:833 PRINCETON AVE SW STE 200E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1321
Practice Address - Country:US
Practice Address - Phone:205-783-3098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery