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Individual

DR. WILLIAM REVELLE PHIPPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12200 W 106TH ST, SUITE 120, OVERLAND PARK, KS 66215-2305
(913) 894-2323
(913) 894-0841
Mailing address
12200 W 106TH ST, SUITE 120, OVERLAND PARK, KS 66215-2305
(913) 894-2323
(913) 894-0841

Taxonomy

Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
04-38170
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01262853
NY
01
2075
BLUE SHIELD
NY
01
4418300
AETNA
NY
01
MD428P
PREFERRED CARE
NY
01
P010187220
BLUE CHOICE
NY
Enumeration date
06/27/2006
Last updated
10/13/2016
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