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Individual

DR. RUSSELL E PHILLIPS

Active
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Individual

DR. RUSSELL E PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD015455E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0056423000
INDEPENDENCE BLUE CROSS
PA
01
125370300
DEPT OF LABOR, OWCP
01
PH126779
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/02/2006
Last updated
11/16/2022
Update your record

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