Individual
DR. JASON ANDREW BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
759 45TH AVE, SUITE 101, MUNSTER, IN 46321-2938
(219) 922-6226
Mailing address
759 45TH AVE, SUITE 101, MUNSTER, IN 46321-2938
(219) 922-6226
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01065114A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01065114A
MEDICAL LICENSE
IN
01
—
01065114B
CONTROLLED SUBSTANCE REGISTRATION
IN
01
—
1427215128
BCBS IL
IN
01
—
35-1441433
CSHCS
IN
01
—
351441433
CIGNA
IN
01
—
570331
ANTHEM BCBS
IN
01
—
9401139
AETNA
IN
01
—
IN5114
EYEMED
IN
Enumeration date
05/20/2008
Last updated
03/07/2023
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