Individual
DR. JONATHAN GABRIEL ELI-PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1341 WALTER REED RD, FAYETTEVILLE, NC 28304-4415
(910) 615-3500
(910) 615-3560
Mailing address
1680 DIAGONAL RD, WORTHINGTON, MN 56187-1008
(507) 372-3800
(507) 372-3393
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2024-01736
NC
207V00000X
Obstetrics & Gynecology Physician
234997
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04034680
—
NY
01
—
J400195165
PTAN
NY
Enumeration date
02/11/2009
Last updated
04/23/2025
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