Provider Demographics
NPI:1831432376
Name:PHILIP W CHRIST DO PA
Entity type:Organization
Organization Name:PHILIP W CHRIST DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHRIST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-535-9393
Mailing Address - Street 1:13787 BELCHER RD S
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-4065
Mailing Address - Country:US
Mailing Address - Phone:727-535-9393
Mailing Address - Fax:727-585-7020
Practice Address - Street 1:13787 BELCHER RD S
Practice Address - Street 2:SUITE 330
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4065
Practice Address - Country:US
Practice Address - Phone:727-535-9393
Practice Address - Fax:727-585-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4574207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057041900Medicaid
FL82957Medicare PIN