Individual
EDWARD K. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 LAKELAND SQUARE EXT STE B, FLOWOOD, MS 39232-7607
(601) 936-0890
(601) 936-0891
Mailing address
40 VALLEY STREAM PKWY STE 100, MALVERN, PA 19355-1407
(610) 644-8900
(484) 924-0053
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
9170
MS
2085R0202X
Diagnostic Radiology Physician
Primary
09170
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115950
—
MS
Enumeration date
08/16/2006
Last updated
04/27/2020
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