Healthcare Provider Details

I. General information

NPI: 1275531303
Provider Name (Legal Business Name): ROBERT D. PHILLIPS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 E MAIN ST
GALLATIN TN
37066-2982
US

IV. Provider business mailing address

437 E MAIN ST
GALLATIN TN
37066-2982
US

V. Phone/Fax

Practice location:
  • Phone: 615-452-8705
  • Fax: 615-452-8740
Mailing address:
  • Phone: 615-452-8705
  • Fax: 615-452-8740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number027255
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: