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General NPI Number Information
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NPI Number | 1619902186
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Entity Type | Organization
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Legal Business Name | KAREN N PHILLIPPS MD PA
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 851 CHALET SUZANNE ROAD
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City | LAKE WALES
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State | FL
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Zip | 33859
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Country | US
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Telephone | 863-679-9916
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Fax |
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Provider Business Mailing Address
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Address Line | 851 CHALET SUZANNE RD
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City | LAKE WALES
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State | FL
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Zip | 33859-7759
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Country | US
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Telephone | 863-679-9916
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Fax | 863-679-9826
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. KAREN NICOLE PHILLIPPS
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Credential |
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Telephone | 863-679-9916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME88539
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License Number State | FL
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