Provider Demographics
NPI:1316979255
Name:BROOKS, ROBERT SEAN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SEAN
Last Name:BROOKS
Suffix:
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 1727
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1727
Mailing Address - Country:US
Mailing Address - Phone:970-242-7292
Mailing Address - Fax:
Practice Address - Street 1:2373 G RD STE 160
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1003
Practice Address - Country:US
Practice Address - Phone:970-242-7292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27679208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60005020OtherRAILROAD MEDICARE
CO01276799Medicaid
841117664001OtherROCKY MOUNTAIN HMO
841117664001OtherROCKY MOUNTAIN HMO
A49392Medicare UPIN