MEDICARE: WILLIAM COLLIER PHILLIPS

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	367500000X	Certified Registered Nurse Anesthetist	901987	MS

General Provider Information

NPI Number	:	1629892435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM COLLIER PHILLIPS

Provider Business Mailing Address
First Line	:	874 UNION AVENUE ROOM 325
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-3514
Country	:	US
Telephone Number	:	662-832-6963
Fax Number	:

Provider Business Practice Location Address
First Line	:	874 UNION AVENUE ROOM 325
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-3514
Country	:	US
Telephone Number	:	662-832-6963
Fax Number	:

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

Provider Enumeration Date	:	11/09/2024
Last Update Date	:	03/24/2026

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