Provider Demographics
NPI:1881823250
Name:BROOKER, CHARLES CHRISTOPHER (DO)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:CHRISTOPHER
Last Name:BROOKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4531 N 16TH ST
Mailing Address - Street 2:STE 114
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5344
Mailing Address - Country:US
Mailing Address - Phone:602-274-0078
Mailing Address - Fax:602-266-4477
Practice Address - Street 1:7747 W DEER VALLEY RD
Practice Address - Street 2:STE 250
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2124
Practice Address - Country:US
Practice Address - Phone:623-234-2447
Practice Address - Fax:623-234-2467
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2020-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ05667207R00000X, 208M00000X
AZ005667207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist