Individual
RILEY PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3688 VETERANS MEMORIAL DR, HATTIESBURG, MS 39401-8246
(601) 554-7400
(601) 554-7499
Mailing address
3688 VETERANS MEMORIAL DR STE 200, HATTIESBURG, MS 39401-8246
(601) 554-7400
(601) 554-7499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07821201
—
MS
Enumeration date
02/13/2019
Last updated
05/23/2023
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