Individual
JOHN BROOKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
255 W BUTE ST, NORFOLK, VA 23510-1403
(757) 627-3790
(757) 623-5023
Mailing address
255 W BUTE ST, NORFOLK, VA 23510-1403
(757) 627-3790
(757) 623-5023
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01010-28786
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006081312
—
VA
01
—
541210461
TAX ID
VA
Enumeration date
08/04/2006
Last updated
06/04/2012
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