Individual
MR. THIRSTON S PHILLIPS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 WATER GRANDE BLVD, LITTLE RIVER, SC 29566-8162
(843) 366-4000
(910) 222-3063
Mailing address
PO BOX 31166, MYRTLE BEACH, SC 29588-0020
(910) 495-6287
(910) 222-3063
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
200400575
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136YW
BLUE CROSS AND BLUE SHIEL
NC
01
—
195400
MEDCOST PROVIDER ID
NC
01
—
612107500
OWCP PROVIDER ID
NC
05
—
89136YW
—
NC
05
—
Q0057F
—
SC
Enumeration date
07/11/2006
Last updated
10/27/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us