Individual
PHILLIP ELVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2273
Mailing address
808 BARRETT LN, AUGUSTA, GA 30909-3453
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
13817
GA
Other
Enumeration date
06/11/2022
Last updated
06/11/2022
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