Individual
DR. BLAKE JAY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1205 W BROADWAY, COLUMBIA, MO 65203-2125
(573) 499-0642
(573) 449-1787
Mailing address
1205 W BROADWAY, COLUMBIA, MO 65203-2125
(573) 499-0642
(573) 449-1787
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
119892
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000623655
HUMANA
MO
01
—
110245813
RAILROAD MEDICARE
MO
01
—
143480
GROUP HEALTH PLANS
MO
01
—
178793
BLUE CROSS BLUE SHIELD
MO
01
—
1963097
FIRST HEALTH
MO
05
—
208373407
—
MO
01
—
3100264
UNITED HEALTHCARE
MO
01
—
42482
HEALTHCARE USA
MO
01
—
431535214
TRICARE
MO
01
—
539285
HEALTHLINK
MO
01
—
7359531
AETNA
MO
01
—
H51820
MERCY
MO
01
—
P01764602
RAILROAD MEDICARE
MO
Enumeration date
06/23/2005
Last updated
10/05/2022
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