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
Fax: (928) 774-2001
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528155082 NPPES
Arizona MEDICAID 973108

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