Provider Demographics
NPI:1497599559
Name:BROOKS, ELEANOR (BS AND MED)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:BS AND MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4734
Mailing Address - Country:US
Mailing Address - Phone:706-610-0515
Mailing Address - Fax:
Practice Address - Street 1:5644 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4734
Practice Address - Country:US
Practice Address - Phone:706-610-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator