Organization
TRIAD ENT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JEROME PHILLIPS M.D. (OWNER)
(336) 249-3551
Entity
Organization
Contact information
Practice address
106 W MEDICAL PARK DR, SUITE C, LEXINGTON, NC 27292-6853
(336) 249-3551
(336) 249-2697
Mailing address
PO BOX 536, LEXINGTON, NC 27293-0536
(336) 249-3551
(336) 249-2697
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
38408
NC
Other
Enumeration date
10/04/2006
Last updated
02/16/2010
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