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NPI Code Detail

MEDICARE: P PERRY PHILLIPS MD

MEDICARE: P PERRY 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
1207Y00000XOtolaryngology Physician32128WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871542092
Entity Type Code : Individual
Provider Name (Legal Business Name) : P PERRY PHILLIPS MD
Provider Business Mailing Address
First Line : 1622 GOLF VIEW DR W
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-3454
Country : US
Telephone Number : 920-457-8468
Fax Number :
Provider Business Practice Location Address
First Line : 2629 N 7TH ST
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-4932
Country : US
Telephone Number : 920-451-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2006
Last Update Date : 11/30/2021

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Directions to “ P PERRY PHILLIPS MD” Practice Location

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