Individual
MR. CHAD M BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 747-1001
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 747-1001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
104187
NC
363A00000X
Physician Assistant
Primary
1497
TN
363AS0400X
Surgical Physician Assistant
1497
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08057569
—
MS
05
—
Q067968
—
TN
Enumeration date
10/02/2006
Last updated
10/06/2022
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