Individual
DR. CHARLES L BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6850 HILLTOP RD, SUITE 170, SHAWNEE, KS 66226-3532
(913) 248-8008
(913) 248-8668
Mailing address
6850 HILLTOP RD, SUITE 170, SHAWNEE, KS 66226-3532
(913) 248-8008
(913) 248-8668
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
18703
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18703
STATE LICENSE
KS
01
—
200325360
TAXPAYER ID NUMBER
—
05
—
202138814
—
MO
05
—
2051807501
—
KS
01
—
MD116172
STATE LICENSE
MO
Enumeration date
05/09/2006
Last updated
09/30/2024
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