Individual provider · Type 1 NPI

Johnnie Ray Brooks, PA-C

Surgical Physician Assistant · Jacksonville, FL

NPI number 1063436848 Active

Practice location

1503 Oak St
Jacksonville, FL 32204-3910

Call (904) 634-0640 Map

Mailing address

7305 Purple Avens Ave
Upper Marlboro, MD 20772-6327

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA 9103751 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1063436848

Johnnie Ray Brooks, PA-C's National Provider Identifier is 1063436848, issued on Jul 26, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Jacksonville, FL. The record was last updated on Jul 8, 2007.