Individual
JEFFREY A BROOKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
524 BRANCH CT, COLUMBIA CITY, IN 46725-1323
(260) 244-7600
(260) 248-8555
Mailing address
3702 NEW VISION DR, STE B, FORT WAYNE, IN 46845-1703
(260) 266-8210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031142A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000327202
ANTHEM
IN
01
—
000000576567
ANTHEM
IN
05
—
100263090A
—
IN
Enumeration date
07/31/2006
Last updated
04/09/2018
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