Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 23429 | AZ |
NPI | 1194795385 |
---|---|
Provider Name | Robert Joseph Brownsberger |
First Address | Flagstaff, AZ 86001-3253 |
Second Address | Flagstaff, AZ 86001-3253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
320763 | (05) | AZ |
F42409 | (02) |