Healthcare Provider Details

I. General information

NPI: 1164476800
Provider Name (Legal Business Name): CLAUDIA ANN PHILLIPS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341 TUDOR CENTRE DR
ANCHORAGE AK
99508-5904
US

IV. Provider business mailing address

4341 TUDOR CENTRE DR
ANCHORAGE AK
99508-5904
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-2500
  • Fax: 907-729-5188
Mailing address:
  • Phone: 907-729-2500
  • Fax: 907-729-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number5733
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: