MEDICARE: DR. THOMAS WILSON 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	2085R0001X	Radiation Oncology Physician	0012112	GA

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

General Provider Information

NPI Number	:	1487655528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS WILSON PHILLIPS MD.

Provider Business Mailing Address
First Line	:	3495 PIEDMONT ROAD, NE
Second Line	:	NINE PIEDMONT CENTER
City	:	ATLANTA
State	:	GA
Zip	:	30305
Country	:	US
Telephone Number	:	404-364-7070
Fax Number	:	770-693-6039

Provider Business Practice Location Address
First Line	:	20 GLENLAKE PKWY
Second Line	:	RADIATION ONCOLOGY
City	:	ATLANTA
State	:	GA
Zip	:	30328
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:	404-851-6010

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/31/2026

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