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General NPI Number Information
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NPI Number | 1174792790
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Entity Type | Organization
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Legal Business Name | PHILLIPS MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 909 ELLIS AVE STE 16
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City | JACKSON
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State | MS
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Zip | 39209-6256
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Country | US
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Telephone | 601-948-8503
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Fax | 601-948-8502
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Provider Business Mailing Address
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Address Line | 909 ELLIS AVE STE 16
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City | JACKSON
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State | MS
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Zip | 39209-6256
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Country | US
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Telephone | 601-948-8503
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Fax | 601-948-8502
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Authorized Official
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Title or Position | BILLER
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Name | TRICIA DUNCAN
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Credential |
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Telephone | 601-878-6945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10785
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License Number State | MS
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