Provider Demographics
NPI:1003996877
Name:BAZLEY, MICHAEL AUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:AUSTIN
Last Name:BAZLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1612
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-1612
Mailing Address - Country:US
Mailing Address - Phone:828-367-6881
Mailing Address - Fax:
Practice Address - Street 1:125 BLEACHERY BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-8209
Practice Address - Country:US
Practice Address - Phone:828-298-8182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist