Individual provider · NPI-1

Dr. Jason Brooks, MD

Family Medicine · Palmer, AK

NPI number1164465712
StatusActive
Last updated in NPPESMar 12, 2014

Details

NPI
1164465712
Entity type
Individual (NPI-1)
Name
Dr. Jason Brooks
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 13, 2006
Last updated
Mar 12, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine4291AKYes

Practice location

634 S Bailey St
Ste 104
Palmer, AK 99645-6330

Phone 907-746-2345

Mailing address

634 S Bailey St
Ste 104
Palmer, AK 99645-6330

Phone 907-746-2345

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