Provider Demographics
NPI:1356345342
Name:MORELOCK, BROOKS (MD)
Entity type:Individual
Prefix:DR
First Name:BROOKS
Middle Name:
Last Name:MORELOCK
Suffix:
Gender:M
Credentials:MD
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 37087
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3087
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-687-6285
Practice Address - Street 1:401 TAKOMA AVE
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4647
Practice Address - Country:US
Practice Address - Phone:423-278-1743
Practice Address - Fax:423-278-1667
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2013-12-13
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-05-02
Provider Licenses
StateLicense IDTaxonomies
TNMD0000030796207R00000X
TNMD30796208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3384756Medicaid
TNH09874Medicare UPIN
TN3384756Medicaid