| Organization Name: | ALICE J. BROOKS, MD, PA |
| NPI Number: | 1093762171 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALICE JOYCE BROOKS (PRESIDENT) |
| Mailing Address: | 116 Standard Warehouse Rd Lugoff |
| State: | SC US |
| Postal Code: | 290789670 |
| Phone Number: | 8034386023 |
| Fax Number: | 8034383671 |
| NPI Enumeration Date: | 05/27/2006 |
| NPI Last Update Date: | 06/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 14008 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |