Provider Demographics
NPI:1366706152
Name:HEAD, BRIAN CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:HEAD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1324 LAKELAND HILLS BLVD
Mailing Address - Street 2:EMERGENCY DEPARTMENT (LAKELAND REGIONAL HEALTH)
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4543
Mailing Address - Country:US
Mailing Address - Phone:863-687-1359
Mailing Address - Fax:863-284-1621
Practice Address - Street 1:1324 LAKELAND HILLS BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT (LAKELAND REGIONAL HEALTH)
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4543
Practice Address - Country:US
Practice Address - Phone:863-687-1359
Practice Address - Fax:863-284-1621
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2015-06-29
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Provider Licenses
StateLicense IDTaxonomies
FLTRN17589390200000X
FLME 122748207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program