MEDICARE: ELIZABETH LEWIS PHILLIPS MD

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
1	207P00000X	Emergency Medicine Physician	37672	TN
2	207P00000X	Emergency Medicine Physician	47364	KY
3	207P00000X	Emergency Medicine Physician	MD.22988	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	515-44826	OTHER	AL	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1144260704	OTHER	AL	TRICARE SOUTH
7	515-44828	OTHER	AL	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144260704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LEWIS PHILLIPS MD

Provider Business Mailing Address
First Line	:	415 E PINE ST APT 1621
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-6628
Country	:	US
Telephone Number	:	205-613-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 E PINE ST APT 1621
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-6628
Country	:	US
Telephone Number	:	205-613-0860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/17/2020

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