Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | ME 92677 | FL |
NPI | 1174503460 |
---|---|
Provider Name | Philip Andrew Townsend |
First Address | Brooksville, FL 34613-7372 |
Second Address | Brooksville, FL 34613-7372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 04/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D49814 | (02) |