Provider Demographics
NPI:1982672259
Name:SALISBURY, BRIAN GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:GREGORY
Last Name:SALISBURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 S FORT HARRISON AVE
Mailing Address - Street 2:BLDG D
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3301
Mailing Address - Country:US
Mailing Address - Phone:727-441-9444
Mailing Address - Fax:727-443-2728
Practice Address - Street 1:1305 S FORT HARRISON AVE
Practice Address - Street 2:BLDG D
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3301
Practice Address - Country:US
Practice Address - Phone:727-441-9444
Practice Address - Fax:727-443-2728
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0023852207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054956800Medicaid
FLD53755Medicare UPIN
FL054956800Medicaid