Provider Demographics
NPI:1811559024
Name:BROOKS, VIKARMA (OD)
Entity Type:Individual
Prefix:
First Name:VIKARMA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8705 DONNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3821
Mailing Address - Country:US
Mailing Address - Phone:813-763-2364
Mailing Address - Fax:
Practice Address - Street 1:1201 N BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4229
Practice Address - Country:US
Practice Address - Phone:919-934-8152
Practice Address - Fax:919-934-8154
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2601152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist