Healthcare Provider Details

I. General information

NPI: 1962496372
Provider Name (Legal Business Name): ANTHONY SCOTT PHILLIPS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11015 W 75TH ST
SHAWNEE KS
66214-1107
US

IV. Provider business mailing address

11015 W 75TH ST
SHAWNEE KS
66214-1107
US

V. Phone/Fax

Practice location:
  • Phone: 913-631-8888
  • Fax: 913-962-1627
Mailing address:
  • Phone: 913-631-8888
  • Fax: 913-962-1627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-04294
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number01-04294
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: