Organization Name: | BROOKS ALLISON, MD PC |
NPI Number: | 1053374876 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARCHIE BROOKS ALLISON (CEO) |
Mailing Address: | 2100 W Sunset Dr Riverton |
State: | WY US |
Postal Code: | 825012274 |
Phone Number: | 3078573590 |
Fax Number: | 3078573553 |
NPI Enumeration Date: | 04/11/2006 |
NPI Last Update Date: | 07/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 4404A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |