# ROBERT L. PHILLIPS, O.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053581967
- **Authorized official:** ROBERT L. PHILLIPS O.D. (OWNER)
- **Authorized official phone:** (904) 387-0025

## Contact information

- **Practice address:** 1580 BLANDING BLVD, JACKSONVILLE, FL 32210-1834
- **Practice address phone:** (904) 387-0025
- **Practice address fax:** (904) 387-0969
- **Mailing address:** 1580 BLANDING BLVD, JACKSONVILLE, FL 32210-1834
- **Mailing address phone:** (904) 387-0025
- **Mailing address fax:** (904) 387-0969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC930 | FL | Yes |

## Other

- **Enumeration date:** 03/06/2008
- **Last updated:** 04/09/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 084322900 | — | FL |
| 05 | — | 084322901 | — | FL |