Provider Demographics
NPI:1992009690
Name:EARL B. BRITT, M.D., P.A.
Entity Type:Organization
Organization Name:EARL B. BRITT, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:850-877-3154
Mailing Address - Street 1:1625 PHYSICIANS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4620
Mailing Address - Country:US
Mailing Address - Phone:850-877-3154
Mailing Address - Fax:850-877-9495
Practice Address - Street 1:1625 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4620
Practice Address - Country:US
Practice Address - Phone:850-877-3154
Practice Address - Fax:850-877-9495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026016207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32029Medicare PIN
D54262Medicare UPIN