Provider Demographics
NPI:1285724260
Name:BROOKS, GREGORY TOOD (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:TOOD
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:212 29TH AVE NE STE 1
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1085
Mailing Address - Country:US
Mailing Address - Phone:828-732-5350
Mailing Address - Fax:828-732-5351
Practice Address - Street 1:212 29TH AVE NE STE 1
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1085
Practice Address - Country:US
Practice Address - Phone:828-732-5350
Practice Address - Fax:828-732-5351
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9900780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG97896Medicare UPIN
NCNCP324A968Medicare Oscar/Certification
NC2278953CMedicare ID - Type Unspecified