Individual
PHILIP RUDOLPH LETTIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA11311100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2018
Last updated
11/27/2023
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