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DR. DEAN CARL BROOME M.D,

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1356548002

Individual Registrant:
DR. DEAN CARL BROOME M.D,
Gender: M
Sole Proprietor

Location and contact information for practice:
115 MAIN ST  BLACKSHEAR, GA 31516-0271 US
Tel: 912-449-1477  Fax: 912-449-1479

Contact information for business:
115 MAIN ST PO BOX 271 BLACKSHEAR, GA 31516-0271 US
Tel: 912-449-1477  Fax: --

Registration Information:
NPI: 1356548002
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
X207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
GA048604
X208000000XAllopathic & Osteopathic Physicians
Pediatrics
GA048604
X2080A0000XAllopathic & Osteopathic Physicians
Pediatrics
GA048604
X2080P0205XAllopathic & Osteopathic Physicians
Pediatrics
GA048604
X209800000XAllopathic & Osteopathic Physicians
Legal Medicine
GA048604

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00886872AGA05




HEALTH CARE JOBS GA - Page 1



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