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NPI Code Detail

MEDICARE: SUSAN J PHILLIPS M. D.

MEDICARE:   SUSAN J PHILLIPS  M. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician9924AL

General Provider Information

NPI Number : 1073664389
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN J PHILLIPS M. D.
Provider Business Mailing Address
First Line : 2470 ROCKY RIDGE RD
Second Line : SUITE 200
City : VESTAVIA
State : AL
Zip : 35243-2833
Country : US
Telephone Number : 205-286-3200
Fax Number : 205-286-3201
Provider Business Practice Location Address
First Line : 2470 ROCKY RIDGE RD
Second Line : SUITE 200
City : VESTAVIA
State : AL
Zip : 35243-2833
Country : US
Telephone Number : 205-286-3200
Fax Number : 205-286-3201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 01/27/2016

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Directions to “ SUSAN J PHILLIPS M. D.” Practice Location

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