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Individual

DR. KENNETH LYNN BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1637
Mailing address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1637

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301059207
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
407115
AZ
Enumeration date
10/12/2006
Last updated
07/09/2007
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