Individual
DR. GREGORY ELLIS PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
230 N MORTON ST, BLOOMINGTON, IN 47404-3964
(812) 323-7000
Mailing address
1752 TIPTON POINT CT, COLUMBUS, IN 47201-5112
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12008604
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100083240A
—
IN
Enumeration date
11/22/2006
Last updated
07/28/2025
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