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General NPI Number Information
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NPI Number | 1285633263
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Entity Type | Individual
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Provider Name | ZACHARY KEITH PHILLIPS MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 5018 CAHABA RIVER RD
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City | VESTAVIA
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State | AL
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Zip | 35243-2317
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Country | US
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Telephone | 205-397-5200
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Fax | 205-203-9858
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | FORTSON
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State | GA
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Zip | 31808-0370
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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 |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-301
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.301
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License Number State | AL
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