Individual
JONATHAN S PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 868-8252
(814) 868-8170
Mailing address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 868-8252
(814) 868-8170
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS 0213373
PA
207R00000X
Internal Medicine Physician
Primary
OS013373
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101891982
—
PA
Enumeration date
01/08/2007
Last updated
09/15/2008
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