Individual
ANTHONY DERRAL PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
300 CHINA GULCH RD, JACKSONVILLE, OR 97530-9744
(541) 899-4911
(541) 899-4911
Mailing address
300 CHINA GULCH RD, JACKSONVILLE, OR 97530-9744
(541) 899-4911
(541) 899-4911
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
099006484RN
OR
163WX0200X
Oncology Registered Nurse
099006484RN
OR
Other
Enumeration date
12/10/2008
Last updated
12/10/2008
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