Provider Demographics
NPI:1679664577
Name:BABLER, BRYAN C (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:C
Last Name:BABLER
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 1:618 ONDOSSAGON WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719
Mailing Address - Country:US
Mailing Address - Phone:608-829-3763
Mailing Address - Fax:
Practice Address - Street 1:2500 OVERLOOK TERRACE
Practice Address - Street 2:DEPT 119
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2286
Practice Address - Country:US
Practice Address - Phone:608-256-1901
Practice Address - Fax:608-280-7279
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9931-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist