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Individual

DANIEL R BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
222 N 2ND ST, STE 215, BOISE, ID 83702-6109
(208) 381-6910
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
25770
OK
207W00000X
Ophthalmology Physician
Primary
M11420
ID
207W00000X
Ophthalmology Physician
MD0000045920
TN

Other

Enumeration date
07/24/2007
Last updated
09/17/2012
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