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NPI Code Detail

MEDICARE: DR. WILLIAM WALTER PHILLIPS DO

MEDICARE: DR. WILLIAM WALTER PHILLIPS DO
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
1207P00000XEmergency Medicine Physician5101007415MI
2207Q00000XFamily Medicine Physician5101007415MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20G71004OTHERMIRHC BLUE CROSS

General Provider Information

NPI Number : 1558349746
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM WALTER PHILLIPS DO
Provider Business Mailing Address
First Line : 7870W HWY US2
Second Line :
City : MANISTIQUE
State : MI
Zip : 49854-1522
Country : US
Telephone Number : 906-341-2153
Fax Number : 906-341-3299
Provider Business Practice Location Address
First Line : 7870W US HIGHWAY 2
Second Line :
City : MANISTIQUE
State : MI
Zip : 49854-8992
Country : US
Telephone Number : 906-341-2153
Fax Number : 906-341-3299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 01/28/2014

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Directions to “ DR. WILLIAM WALTER PHILLIPS DO” Practice Location

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