Organization
BOBBY J. BROOKS, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY J. BROOKS M.D. (PRESIDENT)
(270) 789-3410
Entity
Organization
Contact information
Practice address
127 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9634
(270) 789-3410
(270) 465-2449
Mailing address
127 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9634
(270) 789-3410
(270) 465-2449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051793
ANTHEM
KY
01
—
01-00154
UNITED HEALTHCARE
KY
05
—
65902504
—
KY
05
—
78901006
—
KY
Enumeration date
03/01/2007
Last updated
03/25/2008
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