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General NPI Number Information
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NPI Number | 1689643637
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Entity Type | Individual
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Provider Name | PHILIP E FIDLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1600 COIT RD STE 305
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City | PLANO
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State | TX
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Zip | 75075-6172
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Country | US
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Telephone | 706-863-9595
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Fax | 706-868-8375
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Provider Business Mailing Address
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Address Line | PO BOX 12187
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City | AUGUSTA
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State | GA
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Zip | 30914-2187
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Country | US
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Telephone | 706-863-9595
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Fax | 706-868-8375
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 19524
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | R8186
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 0101273072
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 10838A
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License Number State | WY
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Taxonomy #5
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | ME152606
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | CDRH.0055039
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License Number State | CO
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Taxonomy #7
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD0000064204
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MC-0432
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License Number State | ID
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Taxonomy #9
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 73960
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 27572
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License Number State | MS
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Taxonomy #11
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R8186
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License Number State | TX
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