Provider Demographics
NPI:1710144787
Name:STUBSON, BRETT ALAN (MS RPH)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:ALAN
Last Name:STUBSON
Suffix:
Gender:M
Credentials:MS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 SADDLEBACK TRL
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-9401
Mailing Address - Country:US
Mailing Address - Phone:406-237-8112
Mailing Address - Fax:406-237-8146
Practice Address - Street 1:1233 N 30TH ST
Practice Address - Street 2:DEPT OF PHARMACY ST VINCENT HEALTHCARE
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101
Practice Address - Country:US
Practice Address - Phone:406-237-8112
Practice Address - Fax:406-237-8146
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist