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General NPI Number Information
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NPI Number | 1619172947
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Entity Type | Individual
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Provider Name | MATHEW TODD PHILLIPS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 8620 BIGGIN HILL LN
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City | LOUISVILLE
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State | KY
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Zip | 40220-4117
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Country | US
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Telephone | 859-817-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 560 S LOOP RD
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City | EDGEWOOD
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State | KY
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Zip | 41017-3405
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Country | US
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Telephone | 859-817-3599
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036143518
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35127665
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 43615
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 01067795A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 43615
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License Number State | KY
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