Provider Demographics
NPI:1477834885
Name:AUSTIN, DORIAN J (PHARM,D, RPH)
Entity type:Individual
Prefix:DR
First Name:DORIAN
Middle Name:J
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PHARM,D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 CASSAT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-4717
Mailing Address - Country:US
Mailing Address - Phone:904-693-3321
Mailing Address - Fax:904-693-9694
Practice Address - Street 1:5108 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-5032
Practice Address - Country:US
Practice Address - Phone:904-768-4491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLPS47057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist