DR. JORDAN BROOKS (NPI# 1902225030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902225030 |
| Entity Type | Individual |
| Full Name | DR. JORDAN BROOKS |
| Credential | MD |
| Practice Address |
1007 Harbor Hills Dr Ste C Marquette MI 49855 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 9062255458 |
| Practice Fax Number | 9062251179 |
| Mailing Telephone | 9206639008 |
| Mailing Fax Number | 9206841439 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 71818-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 4301113739 | MI | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
4301113739 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1414 W Fair Ave Ste 109, Marquette, MI 498555404 | 9062253939 | 9062257488 |
| 188 Rockwood Ln Ste A, Neenah, WI 549561983 | 9207254100 | 9207255528 |
| 3500 Ludington St Ste 300, Escanaba, MI 498294218 | 9065536093 | 9065536958 |
| 3515 Murray St, Marinette, WI 541433367 | 7157320699 | 7157323522 |
| 500 Campus Dr, Hancock, MI 499301452 | 9065232223 | 9065232227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326507690 | Jordan Elliot Brooks | Behavior Technician | 7226 Sepulveda Blvd., Van Nuys, CA 91405 | 2019-03-17 |
| 1265988349 | Jordan Lee Brooks | Counselor | 1601 E 4th Plain Blvd Ste 212, Vancouver, WA 98661-3713 | 2016-08-29 |
| 1851488241 | Jordan Trotter Brooks | Optometrist | 8890 Salrose Ln, Suite #203, Fort Myers, FL 33912-2085 | 2006-10-06 |
| 1083226948 | Jordan Alford Brooks | Counselor | 500 Old Lynchburg Rd, Charlottesville, VA 22903-6500 | 2020-08-20 |
| 1508474834 | Jordan Brooks | Social Worker | 1507 Riverside Ave Unit 200, Fort Collins, CO 80524-4383 | 2020-07-22 |
| 1346897592 | Jordan Brooks | Student in an Organized Health Care Education/Training Program | 2712 Telegraph Ave, Berkeley, CA 94705-1117 | 2019-08-22 |
| 1700310489 | Jordan Brooks | Dental Hygienist | 43 S Lubec Rd, Lubec, ME 04652-3620 | 2017-04-19 |
| 1619306586 | Jordan I Brooks | Nurse Practitioner | 1801 N Senate Blvd, Suite 535, Indianapolis, IN 46202-1228 | 2013-11-01 |
| 1700986874 | Jordan Alan Brooks | Psychiatry & Neurology | 4100 W 3rd St, Dayton, OH 45428-9000 | 2006-09-25 |
| Street Address |
1007 HARBOR HILLS DR STE C |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831231083 | Dennis A. Herzog, M.d.,p.c | Dermatology | 1414 W Fair Ave Ste 240, Marquette, MI 49855-5409 | 2007-02-13 |
| 1255446506 | Milton D Soderberg | Dermatology | 1414 W Fair Ave Ste 109, Marquette, MI 49855-5404 | 2006-08-20 |
| 1952658593 | Dlp Marquette Physician Practices Inc | Dermatology | 1414 W Fair Ave, Ste 242, Marquette, MI 49855-2675 | 2012-08-14 |
| 1578756854 | Jennifer P. Baldwin, M.d., P.l.c. | Dermatology | 1414 W Fair Ave, Suite 342, Marquette, MI 49855-2675 | 2007-08-21 |
| 1700836855 | Dennis A Herzog | Dermatology | 1414 W Fair Ave, Suite 240, Marquette, MI 49855-2675 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595616 | Diamond Dermatology, Pllc. | Dermatology | 3206 N Main St, Royal Oak, MI 48073-3424 | 2020-07-16 |
| 1477179174 | Alicia Scopis | Dermatology | 50505 Schoenherr Rd Ste 325, Shelby Township, MI 48315-3142 | 2020-06-18 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1770080939 | Emily Rose Davis | Dermatology | 5333 Mcauley Dr Rm 2111, Ypsilanti, MI 48197-1097 | 2018-04-12 |
| 1245744242 | Maureen Cliffel Do Pllc | Dermatology | 26454 Woodward Ave Ste 200, Royal Oak, MI 48067-0969 | 2017-11-29 |
| 1306375365 | Lindsay Christina El Awadi | Dermatology | 50182 Schoenherr Rd, Shelby Twp, MI 48315-3136 | 2017-06-05 |
| 1396278099 | Sasank Konda | Dermatology | 3031 W. Grand Blvd., 8th Floor, Dept. of Dermatology, Detroit, MI 48202 | 2017-04-10 |
| 1790132439 | Saara Kanervikkoaho-crane | Dermatology | 1517 Granger Ave, Ann Arbor, MI 48104-4426 | 2016-05-23 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1679955041 | Luke D Killpack | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2015-06-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.