Individual
MR. JOHN RICHARD PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13255 W BLUEMOUND RD, SUITE 103, BROOKFIELD, WI 53005-6245
(262) 786-2875
(262) 786-2096
Mailing address
13255 W BLUEMOUND RD, SUITE 103, BROOKFIELD, WI 53005-6245
(262) 786-2875
(262) 786-2096
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17714
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000368010
PTIN
WI
05
—
31211900
—
WI
Enumeration date
03/28/2006
Last updated
04/14/2009
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