Individual
CHARLES EDWARD PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2035 PROFESSIONAL CTR DR, STE C, ORANGE PARK, FL 32073
(904) 272-0384
(904) 272-6748
Mailing address
2035 PROFESSIONAL CTR DR, STE C, ORANGE PARK, FL 32073
(904) 272-0384
(904) 272-6748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME32937
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037423700
—
FL
Enumeration date
05/01/2006
Last updated
01/20/2010
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