# DR. PHILLIP H OMOHUNDRO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1871553594
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | D25458 | MD | Yes |
| 207X00000X | Orthopaedic Surgery Physician | MD13399 | DC | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | D0025458 | MD | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | MD13399 | DC | — |

## Other

- **Enumeration date:** 03/25/2006
- **Last updated:** 01/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0150330001 | — | MD |