Individual
DR. GERRY MADISON PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6701 AIRPORT BLVD, SUITE D-330, MOBILE, AL 36608-6705
(251) 607-9797
(251) 607-7696
Mailing address
6701 AIRPORT BLVD, SUITE D-330, MOBILE, AL 36608-6705
(251) 607-9797
(251) 607-9761
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
00009788
AL
207RI0011X
Interventional Cardiology Physician
00009788
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000013881
—
AL
05
—
0112493
—
MS
01
—
510-13881
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/12/2006
Last updated
11/30/2016
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