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General NPI Number Information
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NPI Number | 1306344031
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Entity Type | Organization
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Legal Business Name | DR. RONALD B PHILLIPS AND ASSOCIATES PC
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 648A E CHESTER PIKE
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City | RIDLEY PARK
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State | PA
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Zip | 19078-1701
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Country | US
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Telephone | 610-237-0100
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Fax | 610-237-0114
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Provider Business Mailing Address
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Address Line | 648A E CHESTER PIKE
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City | RIDLEY PARK
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State | PA
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Zip | 19078-1701
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Country | US
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Telephone | 610-237-0100
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Fax | 610-237-0114
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Authorized Official
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Title or Position | DR
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Name | DR. RONALD B PHILLIPS
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Credential | DO
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Telephone | 610-237-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | OS002996L
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License Number State | PA
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