MEDICARE: DR. JAMES E 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
1	261QC1800X	Corporate Health Clinic/Center	MD0000014226	TN

General Provider Information

NPI Number	:	1861653891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E PHILLIPS M.D.

Provider Business Mailing Address
First Line	:	1 BETHEL VALLEY RD
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-8050
Country	:	US
Telephone Number	:	865-574-7431
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BETHEL VALLEY RD
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-8050
Country	:	US
Telephone Number	:	865-574-7431
Fax Number	:

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

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	06/23/2008

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