Doctor Name: | GLENN H BIRKITT |
NPI Number: | 1366559684 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD0000020672 |
Business Practice Address: | 1 Medical Park Blvd 250 West Bristol, TN - 376207431 |
Business Phone Number: | 4238446620 |
Business Fax Number: | 4238446626 |
Mailing Address: | 1 Medical Park Blvd, 250 West BRISTOL |
State: | TN |
Postal Code: | 376207430 |
Phone Number: | 4238446620 |
Fax Number: | 4238446626 |
NPI Enumeration Date: | 08/23/2006 |
NPI Last Update Date: | 06/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD0000020672 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |