Individual
DR. JOHN KENNETH PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 STADIUM BLVD, JONESBORO, AR 72401-7415
(870) 934-5113
(870) 392-3608
Mailing address
PO BOX 1960, PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 936-1043
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E0129
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129236001
—
AR
05
—
208891804
—
MO
Enumeration date
06/08/2005
Last updated
12/01/2016
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