Provider Demographics
NPI:1740823103
Name:WILLIAM JAMES BROOKS, DO, PC.
Entity type:Organization
Organization Name:WILLIAM JAMES BROOKS, DO, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:816-746-0128
Mailing Address - Street 1:5363 E PIMA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3663
Mailing Address - Country:US
Mailing Address - Phone:816-746-0128
Mailing Address - Fax:520-269-6339
Practice Address - Street 1:5281 N VIA SEMPREVERDE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-5968
Practice Address - Country:US
Practice Address - Phone:816-746-0128
Practice Address - Fax:877-794-8238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ220939Medicaid