Provider Demographics
NPI:1073702544
Name:MILKS, BRIAN DALE (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:DALE
Last Name:MILKS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-2327
Mailing Address - Country:US
Mailing Address - Phone:814-677-2215
Mailing Address - Fax:
Practice Address - Street 1:508 E 2ND ST
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-2327
Practice Address - Country:US
Practice Address - Phone:814-677-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042579L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist