MEDICARE: TODD C 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	207P00000X	Emergency Medicine Physician	42655	WI
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	42655	WI

General Provider Information

NPI Number	:	1538161773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD C PHILLIPS MD

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0002
Country	:	US
Telephone Number	:	608-785-0940
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 WEST AVE S
Second Line	:
City	:	LA CROSSE
State	:	WI
Zip	:	54601-4783
Country	:	US
Telephone Number	:	608-785-0940
Fax Number	:

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	12/06/2021

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Directions to “ TODD C PHILLIPS MD” Practice Location

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