Provider Demographics
NPI:1194788687
Name:BROOKS, JAMES G JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:BROOKS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-5642
Mailing Address - Country:US
Mailing Address - Phone:706-323-3491
Mailing Address - Fax:706-660-9191
Practice Address - Street 1:6600 WHITTLESEY BLVD BLDG A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-7337
Practice Address - Country:US
Practice Address - Phone:706-323-3491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA39057207WX0120X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00618362AMedicaid
GA00618362AMedicaid
GA18BDCWFMedicare ID - Type Unspecified