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General NPI Number Information
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NPI Number | 1598760258
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Entity Type | Individual
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Provider Name | FREDERICK B PHILLIPS JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 4010 NW CACHE RD
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City | LAWTON
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State | OK
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Zip | 73505-3634
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Country | US
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Telephone | 580-357-8688
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Fax | 580-357-7483
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Provider Business Mailing Address
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Address Line | 4010 NW CACHE RD
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City | LAWTON
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State | OK
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Zip | 73505-3634
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Country | US
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Telephone | 580-357-8688
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Fax | 580-357-7483
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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 | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 1907
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 1907
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 1907
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1907
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License Number State | OK
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