Provider Demographics
NPI:1184976722
Name:BROOKS, PAUL JOHN (BC-HIS)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JOHN
Last Name:BROOKS
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12131
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-0131
Mailing Address - Country:US
Mailing Address - Phone:303-668-7744
Mailing Address - Fax:303-668-7744
Practice Address - Street 1:7370 W 52ND AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3708
Practice Address - Country:US
Practice Address - Phone:303-264-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-T-10151316237700000X
CO155237700000X
WAHA 60353175237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist