Organization
DONALD M. PHILLIPS MD. PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY A. WOLOSZYN (BILLING MANAGER)
(219) 942-8518
Entity
Organization
Contact information
Practice address
1356 S LAKE PARK AVE, HOBART, IN 46342-5964
(219) 942-8518
(219) 947-2751
Mailing address
1356 S LAKE PARK AVE, HOBART, IN 46342-5964
(219) 942-8518
(219) 947-2751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01020846A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086604
BLUE CROSS BLUE SHIELD
IN
Enumeration date
10/19/2007
Last updated
10/19/2007
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