Provider Demographics
NPI:1932140498
Name:BROOKS, JOSEPH M (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3920 N UNION BLVD
Mailing Address - Street 2:PREMIER HEALTH PLAZA, SUITE 150
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4900
Mailing Address - Country:US
Mailing Address - Phone:719-598-8155
Mailing Address - Fax:719-598-3188
Practice Address - Street 1:3920 N UNION BLVD
Practice Address - Street 2:PREMIER HEALTH PLAZA, SUITE 150
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4900
Practice Address - Country:US
Practice Address - Phone:719-598-8155
Practice Address - Fax:719-598-3188
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME91065207R00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00631814OtherRR MEDICARE
FL270688101Medicaid
FL270688101Medicaid
FLI17252Medicare UPIN