# BROCKMAN MED CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790091932
- **Authorized official:** DON L BROCKMAN (CEO)
- **Authorized official phone:** (314) 498-2154

## Contact information

- **Practice address:** 101 W ARGONNE DR, SUITE 58, KIRKWOOD, MO 63122-4201
- **Practice address phone:** (314) 498-2154
- **Mailing address:** 101 W ARGONNE DR, SUITE 58, KIRKWOOD, MO 63122-4201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R4P98 | MO | Yes |

## Other

- **Enumeration date:** 08/25/2010
- **Last updated:** 08/25/2010