Provider Demographics
NPI:1316991409
Name:BRAYTON, ALAN D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:BRAYTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 OLD WEST TRL
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7114
Mailing Address - Country:US
Mailing Address - Phone:406-388-4801
Mailing Address - Fax:
Practice Address - Street 1:925 HIGHLAND BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6900
Practice Address - Country:US
Practice Address - Phone:406-585-5030
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist