Organization
LB & KM LLC
Active
Other names
The Doc House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLE L BROOK D.O (PARTNER)
(843) 357-1299
Entity
Organization
Contact information
Practice address
4630 HWY 17 BYPASS, MURRELLS INLET, SC 29576-5016
(843) 357-1299
(843) 357-2264
Mailing address
PO BOX 2747, MURRELLS INLET, SC 29576-2662
(843) 357-1299
(843) 357-2264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO 411
SC
207RC0000X
Cardiovascular Disease Physician
MD17689
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK3853
RAILROAD MEDICARE
SC
05
—
GP3579
—
SC
Enumeration date
03/23/2006
Last updated
09/12/2008
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