Healthcare Provider Details

I. General information

NPI: 1548402837
Provider Name (Legal Business Name): WILLIAM ROBERT CURTISS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W MAIN ST
GAYLORD MI
49735-1859
US

IV. Provider business mailing address

415 W MAIN ST
GAYLORD MI
49735-1859
US

V. Phone/Fax

Practice location:
  • Phone: 989-732-5220
  • Fax: 323-731-4216
Mailing address:
  • Phone: 989-732-5220
  • Fax: 323-731-4216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302021873
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: