Provider Demographics
NPI:1457567711
Name:BIRD & THORNTON PA
Entity Type:Organization
Organization Name:BIRD & THORNTON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-855-1073
Mailing Address - Street 1:PO BOX 940973
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-0973
Mailing Address - Country:US
Mailing Address - Phone:407-855-1073
Mailing Address - Fax:
Practice Address - Street 1:557 N WYMORE RD STE 202
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4200
Practice Address - Country:US
Practice Address - Phone:407-794-8000
Practice Address - Fax:877-409-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0522AMedicare PIN