Individual
ALISSA S BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
300 W HOSPITAL RD, MEDICAL EVALUATION BOARD, FORT GORDON, GA 30905-5741
(315) 767-2571
Mailing address
300 W HOSPITAL RD, MEDICAL EVALUATION BOARD, FORT GORDON, GA 30905-5741
(315) 767-2571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
237512
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354316
—
NY
Enumeration date
05/18/2006
Last updated
10/03/2013
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