Healthcare Provider Details

I. General information

NPI: 1013996446
Provider Name (Legal Business Name): PATRICK TERREL BIRCHFIELD DO, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 HULSE RD
PENSACOLA FL
32508-1089
US

IV. Provider business mailing address

1446 CACAO LN
PENSACOLA FL
32507-7910
US

V. Phone/Fax

Practice location:
  • Phone: 850-452-3154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number02002793A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: