PHILLIPS FAMILY HEALTHCARE LLC NPI 1629457254

NPI Information

PHILLIPS FAMILY HEALTHCARE, LLC is a family nurse practitioner in Marion, AR. PHILLIPS FAMILY HEALTHCARE, LLC NPI is 1629457254. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2921 HWY 77 S
SUITES 12-13
MARION, AR
ZIP 72364-367
Phone: (901) 438-8451

The provider's authorized official is Ted Phillips .
The authorized official title is Owner/practitioner and has the following contact phone number (901) 438-8451.

The CLIA number assigned to this NPI record is 04D2097681 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/28/2015 and was last updated on 5/28/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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