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Individual

DR. MARK A. PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
7640 HIGHWAY 70 S, SUITE 209, NASHVILLE, TN 37221-1758
(615) 646-1141
(615) 646-1149
Mailing address
5005 STONEMEADE DR, NASHVILLE, TN 37221-4046
(615) 646-1141
(615) 646-1149

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
P1513
TN
103T00000X
Psychologist
P1513
TN
103TC0700X
Clinical Psychologist
P1513
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3686357
TN
Enumeration date
01/28/2007
Last updated
01/06/2015
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