Individual
DR. BENJAMIN E PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 BAYSHORE DR, MANITOWOC, WI 54220-5548
(920) 684-4429
(920) 684-6892
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
44214-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0376640002
ADMINASTAR FEDERAL
WI
05
—
34181000
—
WI
Enumeration date
08/18/2005
Last updated
04/10/2024
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