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Individual

ELIZABETH LEWIS PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
415 E PINE ST APT 1621, ORLANDO, FL 32801-6628
(205) 613-0860
Mailing address
415 E PINE ST APT 1621, ORLANDO, FL 32801-6628
(205) 613-0860

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
37672
TN
207P00000X
Emergency Medicine Physician
47364
KY
207P00000X
Emergency Medicine Physician
Primary
MD.22988
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009913013
AL
05
009913632
AL
01
1144260704
TRICARE SOUTH
AL
05
3886731
TN
01
515-44826
BCBS
AL
01
515-44828
BCBS
AL
05
7100535310
KY
Enumeration date
06/08/2006
Last updated
08/17/2020
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