Individual
JOHN A PHILLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1524 ATWOOD AVE, SUITE 245, JOHNSTON, RI 02919-3228
(401) 443-5559
(401) 443-5562
Mailing address
1524 ATWOOD AVE STE 245, JOHNSTON, RI 02919-3228
(401) 443-5559
(401) 443-5562
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
RI08221
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004509
BLUE CHIP #
RI
01
—
1700281
UNITED HEALTHCARE #
RI
05
—
7002899
—
RI
01
—
RI08221
STATE LICENSE #
RI
Enumeration date
11/21/2005
Last updated
12/20/2023
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