Healthcare Provider Details
I. General information
NPI: 1467621599
Provider Name (Legal Business Name): JAMES ROBERT PIORKOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/22/2008
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4012 N 9TH AVE
PENSACOLA FL
32503-2824
US
IV. Provider business mailing address
1040 GULF BREEZE PKWY STE 200
GULF BREEZE FL
32561-7808
US
V. Phone/Fax
- Phone: 850-807-4200
- Fax: 850-916-8499
- Phone: 850-916-3700
- Fax: 850-916-3710
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 2019702 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | 2019702 |
| License Number State | MO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0105X |
| Taxonomy | Surgery of the Hand (Plastic Surgery) Physician |
| License Number | 28641 |
| License Number State | AL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | 28641 |
| License Number State | AL |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | ME137442 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: