Provider Demographics
NPI:1215953104
Name:SEIFERT, MICHAEL J (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:SEIFERT
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 1:8460 N PRAIRIE VW
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315-9176
Mailing Address - Country:US
Mailing Address - Phone:928-772-4232
Mailing Address - Fax:
Practice Address - Street 1:5440 NW 86TH ST
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1737
Practice Address - Country:US
Practice Address - Phone:928-772-7673
Practice Address - Fax:928-772-6283
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14800183500000X
IA14432183500000X
MN112078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist