Provider Demographics
NPI:1902014913
Name:BROOKMAN, ROBERT HORTON (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HORTON
Last Name:BROOKMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 VINE ST
Mailing Address - Street 2:#404
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1122
Mailing Address - Country:US
Mailing Address - Phone:706-347-4944
Mailing Address - Fax:
Practice Address - Street 1:1011 ROWANS VW
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-3886
Practice Address - Country:US
Practice Address - Phone:706-347-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057049207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease