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NPI Code Detail

MEDICARE: DR. BRAD CLINTON PHILLIPS D.V.M.

MEDICARE:  DR. BRAD CLINTON PHILLIPS  D.V.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174M00000XVeterinarianVET7103GA

General Provider Information

NPI Number : 1083866974
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRAD CLINTON PHILLIPS D.V.M.
Provider Business Mailing Address
First Line : 4525 SPRINGWOOD DR
Second Line :
City : MONROE
State : GA
Zip : 30655-8394
Country : US
Telephone Number : 770-266-6167
Fax Number :
Provider Business Practice Location Address
First Line : 1510 PIEDMONT AVE NE
Second Line :
City : ATLANTA
State : GA
Zip : 30324-5032
Country : US
Telephone Number : 404-875-7387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2008
Last Update Date : 10/22/2008

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Directions to “ DR. BRAD CLINTON PHILLIPS D.V.M.” Practice Location

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