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NPI Code Detail

MEDICARE: DR. JASON L. PHILLIPS M.D.

MEDICARE: DR. JASON L. PHILLIPS M.D.
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
1207R00000XInternal Medicine PhysicianMD24245OR

General Provider Information

NPI Number : 1184651853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON L. PHILLIPS M.D.
Provider Business Mailing Address
First Line : 2400 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1221
Country : US
Telephone Number : 503-361-5400
Fax Number :
Provider Business Practice Location Address
First Line : 2400 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1221
Country : US
Telephone Number : 503-361-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 02/04/2022

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