Provider Demographics
NPI:1003100926
Name:BRETTEL, BRIAN DOYLE
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DOYLE
Last Name:BRETTEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 CARL T JONES DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-4913
Mailing Address - Country:US
Mailing Address - Phone:256-883-6295
Mailing Address - Fax:
Practice Address - Street 1:2750 CARL T JONES DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4913
Practice Address - Country:US
Practice Address - Phone:256-883-6295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist