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General NPI Number Information
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NPI Number | 1104453034
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Entity Type | Individual
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Provider Name | VIRGINIA ANN PHILLIPS
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
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City | APO
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State | AE
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Zip | 09180
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Country | US
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Telephone | 314-590-4221
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 402 BOX 1255
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City | APO
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State | AE
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Zip | 09180-0013
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Country | US
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Telephone | 314-590-4221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 39094
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39094
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License Number State | OK
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