Individual
DR. MICHAEL SCOTT PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
829 N NOLAN RIVER RD, CLEBURNE, TX 76033-7085
(817) 558-4600
(817) 468-3438
Mailing address
7100 OAKMONT BLVD STE 205, FORT WORTH, TX 76132-3908
(817) 468-4343
(817) 468-3438
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
K2983
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
K2983
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
K2983
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136902713
MEDICAID-00339K
TX
01
—
136902714
MEDICAID-00606K
TX
01
—
136902716
MEDICAID-00607K
TX
05
—
136902717
—
TX
01
—
8C0801
MEDICARE-00339K
TX
01
—
8D2510
MEDICARE-00606K
TX
01
—
8G7059
BCBS
TX
01
—
8K7832
MEDICARE-00607K
TX
01
—
P00160206
RAILROAD
TX
Enumeration date
12/23/2005
Last updated
05/29/2024
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