This is how your name will be displayed on the account, as well as on documents such as prescriptions that you may write.
This is the phone number that will be associated with your account and used to contact you for questions.
This is the email address that notifications will be sent to regarding your account, new messages, or prescription status updates.
Note: Password must contain at least one uppercase letter, one lowercase letter, one special character or number, and must be at least 8 characters long.
Note: this NPI number is already being used. Would you like to use it anyway? For more information please contact us at firstname.lastname@example.org or call 1-800-daavlin.
This information is used to help verify you or your practice and prevents fraudulent accounts from being created.