Individual
DR. HALEY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329-2206
(248) 861-3750
Mailing address
12 EXECUTIVE PARK DR NE STE 400, ATLANTA, GA 30329-2206
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
85262
GA
390200000X
Student in an Organized Health Care Education/Training Program
11018683A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11018683A
MEDICAL RESIDENCY PERMIT
IN
Enumeration date
05/19/2016
Last updated
09/28/2021
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