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General NPI Number Information
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NPI Number | 1669792453
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Entity Type | Organization
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Legal Business Name | PHILLIPS & PHILLIPS OD PA
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 3100 SW COLLEGE RD INSIDE SEARS OPTICAL
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City | OCALA
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State | FL
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Zip | 34474-7446
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Country | US
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Telephone | 352-291-2020
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Fax | 352-873-9110
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Provider Business Mailing Address
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Address Line | 1620 SE 29TH TER
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City | OCALA
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State | FL
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Zip | 34471-4715
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Country | US
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Telephone | 352-291-2020
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Fax | 352-873-9110
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. SUSAN BREKRUS PHILLIPS
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Credential | O.D.
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Telephone | 352-291-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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