MEDICARE: THOMAS A PHIPPS 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	2084N0400X	Neurology Physician	MD14730	OR
2	2084N0400X	Neurology Physician	14730	OR

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	:	1568467892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS A PHIPPS MD

Provider Business Mailing Address
First Line	:	19260 SW 65TH AVE
Second Line	:	STE 280
City	:	TUALATIN
State	:	OR
Zip	:	97062-5708
Country	:	US
Telephone Number	:	503-692-2850
Fax Number	:	503-692-4465

Provider Business Practice Location Address
First Line	:	19260 SW 65TH AVE
Second Line	:	STE 280
City	:	TUALATIN
State	:	OR
Zip	:	97062-5708
Country	:	US
Telephone Number	:	503-692-2850
Fax Number	:	503-692-4465

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	11/12/2021

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Directions to “ THOMAS A PHIPPS MD” Practice Location

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