MEDICARE: IRA PHILLIPS III 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	2084P0800X	Psychiatry Physician	48353	TN

General Provider Information

NPI Number	:	1588980338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRA PHILLIPS III MD

Provider Business Mailing Address
First Line	:	PO BOX 92202
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-8202
Country	:	US
Telephone Number	:	615-558-5768
Fax Number	:	888-501-4893

Provider Business Practice Location Address
First Line	:	210 25TH AVE N STE 601
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1631
Country	:	US
Telephone Number	:	615-558-5768
Fax Number	:	888-501-4893

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

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	03/13/2023

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