Provider Demographics
NPI:1659751253
Name:BOZEK, BROOKE DOUGLAS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:DOUGLAS
Last Name:BOZEK
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:310 EISENHOWER DR
Mailing Address - Street 2:STE 12A
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-201-1140
Mailing Address - Fax:912-417-4348
Practice Address - Street 1:101 13TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2183
Practice Address - Country:US
Practice Address - Phone:706-494-4949
Practice Address - Fax:706-494-4940
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2020-03-16
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Provider Licenses
StateLicense IDTaxonomies
GA7562363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant