Austin, Glen D.
Austin, Glen D. is an sole proprietor health care provider with primary practice located at 1501 S Yale St Ste# 252, Flagstaff AZ 86001-7304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Austin, Glen D. can be contacted via phone (928) 774-1811.Contact Information
Primary practice address
1501 S Yale St Ste# 252
Flagstaff AZ 86001-7304
Phone: (928) 774-1811
Fax: (928) 774-2001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 4261 | Arizona |
Profile Details
| NPI number | 1528155082 |
|---|---|
| LBN Legal business name | Austin, Glen D. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Jul 22nd, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528155082 | NPPES |
| Arizona | MEDICAID | 973108 |
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