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General NPI Number Information
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NPI Number | 1134209398
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Entity Type | Individual
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Provider Name | DOUGLAS ANTHONY PHILLIPS CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2170 MIDLAND RD
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-2999
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Country | US
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Telephone | 910-295-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 101 ROB ROY RD
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-7225
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Country | US
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Telephone | 912-980-5936
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN162763
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License Number State | GA
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