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General NPI Number Information
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NPI Number | 1265643159
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Entity Type | Individual
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Provider Name | ORVILLE DONALD BROWN III
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3250 N PINAL PKWY PHS MEDICAL CLINIC
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City | FLORENCE
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State | AZ
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Zip | 85232-9459
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Country | US
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Telephone | 520-868-8449
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Fax |
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Provider Business Mailing Address
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Address Line | 2664 S JOPLIN
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City | MESA
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State | AZ
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Zip | 85209-2504
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9244
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License Number State | OK
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