Individual
KENNETH A PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000530
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075457
FIRST PRIORITY
PA
01
—
0829700
AETNA
PA
01
—
18765
GEISINGER
PA
01
—
390770
NVA
PA
01
—
OEG000530
VBA
PA
01
—
PH289044
CLARITY VISION
PA
Enumeration date
11/21/2006
Last updated
07/01/2010
Update your record
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