MEDICARE: DR. DAVID J PHILLIPS MD

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
1	207R00000X	Internal Medicine Physician	27286	TN
2	208M00000X	Hospitalist Physician	27286	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497730212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J PHILLIPS MD

Provider Business Mailing Address
First Line	:	2051-B HAMILL ROAD
Second Line	:	SUITE 103
City	:	HIXSON
State	:	TN
Zip	:	37343-4653
Country	:	US
Telephone Number	:	423-756-8871
Fax Number	:	423-475-8976

Provider Business Practice Location Address
First Line	:	2051-B HAMILL ROAD
Second Line	:	SUITE 103
City	:	HIXSON
State	:	TN
Zip	:	37343-4653
Country	:	US
Telephone Number	:	423-756-8871
Fax Number	:	423-475-8976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	11/24/2010

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Directions to “ DR. DAVID J PHILLIPS MD” Practice Location

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