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General NPI Number Information
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NPI Number | 1245925130
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Entity Type | Organization
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Legal Business Name | PHILLIPS EYE, PLLC
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Dates
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Enumeration Date | 04/07/2023
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 1212 WALTER REED RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4440
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Country | US
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Telephone | 910-574-5009
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 RAEFORD RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDON PHILLIPS
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Credential |
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Telephone | 910-574-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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