# GORDON PHILLIPS IV

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1770143125
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MT219200 | PA | Yes |

## Other

- **Enumeration date:** 06/18/2019
- **Last updated:** 06/28/2019