Individual
MARC H BRICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3120 CLEARWATER DR, PRESCOTT, AZ 86305-7131
(928) 771-3704
(928) 771-0434
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5987
(775) 356-5590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
007470
AZ
207R00000X
Internal Medicine Physician
1126
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11267
—
SC
05
—
347441
—
AZ
01
—
Z210853
MEDICARE PTAN
AZ
Enumeration date
05/16/2006
Last updated
03/19/2018
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