Healthcare Provider Details

I. General information

NPI: 1104561695
Provider Name (Legal Business Name): WILLIAM W PHILIP MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 LINCOLN AVE STE 200
STEAMBOAT SPRINGS CO
80487-4972
US

IV. Provider business mailing address

PO BOX 770240
STEAMBOAT SPRINGS CO
80477-0240
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-7637
  • Fax:
Mailing address:
  • Phone: 970-879-7637
  • Fax: 970-871-6811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MILLIE FLANIGAN
Title or Position: PHYSICIAN ASSISTANT
Credential: PA
Phone: 970-846-7816