Provider Demographics
NPI:1497055883
Name:BRIEN E PIERPONT MD PA
Entity Type:Organization
Organization Name:BRIEN E PIERPONT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIEN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:PIERPONT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-321-7721
Mailing Address - Street 1:2299 9TH AVE N
Mailing Address - Street 2:STE 3C
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6800
Mailing Address - Country:US
Mailing Address - Phone:727-321-7721
Mailing Address - Fax:727-321-6924
Practice Address - Street 1:2299 9TH AVE N
Practice Address - Street 2:STE 3-C
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6800
Practice Address - Country:US
Practice Address - Phone:727-321-7721
Practice Address - Fax:727-321-6924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046164400Medicaid
FL046164400Medicaid
FLDT005Medicare PIN