Individual
JOHN CARLOS BROCKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-5503
(717) 851-5507
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
17400
AL
2084N0400X
Neurology Physician
3110
WI
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
MD482308
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009901225
—
AL
05
—
009938017
—
AL
05
—
04970355
—
MS
01
—
051509854
BLUE CROSS
AL
01
—
051509855
BLUE CROSS
AL
05
—
051509855
—
AL
05
—
100286787
—
WI
01
—
130025436
RAILROAD MEDICARE
AL
Enumeration date
06/07/2006
Last updated
10/18/2024
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