Individual
DR. KELLEY L PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
KELLEY PHILLIPS MD
Contact information
Practice address
875 W MORENO AVE, COLORADO SPRINGS, CO 80905-1731
(719) 572-6100
Mailing address
3322 DENT PL NW, WASHINGTON, DC 20007-2712
(202) 337-8051
(202) 338-4436
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DR.0061894
CO
2084P0800X
Psychiatry Physician
MD13012
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010206758
—
VA
05
—
0488015
—
IA
05
—
13831
—
ND
01
—
185693
BCBS VA
VA
05
—
410407200
—
MD
01
—
60484701
BCBS MD
MD
01
—
G396-0044
BCBS DC
DC
01
—
P00356148
RR MEDICARE IA
IA
01
—
P00384921
RR MEDICARE X
DC
01
—
P00384921
RR MEDICARE S
DE
01
—
P00479398
RR MEDICARE ND
ND
Enumeration date
06/16/2006
Last updated
02/26/2019
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