Individual
JOHN G PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
15110 JOHN J DELANEY DR, SUITE 100, CHARLOTTE, NC 28277-3545
(704) 512-5100
(704) 512-5101
Mailing address
PO BOX 601067, CHARLOTTE, NC 28260-1067
(704) 512-5100
(704) 512-5101
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
11491
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
28075
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114913
—
SC
05
—
1326070111
—
NC
01
—
67621
NC BLUE CROSS BLUE SHIELD
NC
05
—
7905171
—
NC
05
—
8967621
—
NC
Enumeration date
07/06/2006
Last updated
01/11/2017
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