Basic Information
| Provider Information | |||||||||
| NPI: | 1477541548 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROOKE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MEDICAL DOCTOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 241 ROBERT K WILSON DR | ||||||||
| Address2: | |||||||||
| City: | CARROLLTON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354478010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053672408 | ||||||||
| FaxNumber: | 2053679123 | ||||||||
| Practice Location | |||||||||
| Address1: | 241 ROBERT K WILSON DR | ||||||||
| Address2: | |||||||||
| City: | CARROLLTON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354478010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053672408 | ||||||||
| FaxNumber: | 2053679123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 00009384 | AL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.