Fornwalt, Brandon Eugene
Fornwalt, Brandon Eugene is an individual health care provider with primary practice located at 18699 N 67Th Ave Ste 300 , Glendale AZ 85308-7149. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Fornwalt, Brandon Eugene can be contacted via phone (623) 566-4718.Contact Information
Primary practice address
18699 N 67Th Ave Ste 300
Glendale AZ 85308-7149
Phone: (623) 566-4718
Fax: (523) 566-4820
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 009926 | Arizona |
Profile Details
| NPI number | 1912407172 |
|---|---|
| LBN Legal business name | Fornwalt, Brandon Eugene |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2018 |
| Last updated | Jul 3rd, 2023 - about 2 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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