Provider Demographics
NPI:1982766044
Name:PHILIP TOWNSEND MD PA
Entity Type:Organization
Organization Name:PHILIP TOWNSEND MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-799-6700
Mailing Address - Street 1:675 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-2823
Mailing Address - Country:US
Mailing Address - Phone:352-799-6700
Mailing Address - Fax:352-799-6722
Practice Address - Street 1:675 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2823
Practice Address - Country:US
Practice Address - Phone:352-799-6700
Practice Address - Fax:352-799-6722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92677207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8221Medicare PIN
FLD49804Medicare UPIN