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General NPI Number Information
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NPI Number | 1588980338
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Entity Type | Individual
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Provider Name | IRA PHILLIPS III MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 210 25TH AVE N STE 601
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City | NASHVILLE
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State | TN
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Zip | 37203-1631
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Country | US
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Telephone | 615-558-5768
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Fax | 888-501-4893
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Provider Business Mailing Address
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Address Line | PO BOX 92202
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City | NASHVILLE
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State | TN
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Zip | 37209-8202
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Country | US
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Telephone | 615-558-5768
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Fax | 888-501-4893
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 48353
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License Number State | TN
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