Individual
DR. PAUL ARTHUR PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
58 CARROLL STREET, LEBANON, VA 24266
(276) 883-8000
Mailing address
PO BOX 284, DANTE, VA 24237-0284
(276) 608-5684
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102202256
VA
207P00000X
Emergency Medicine Physician
1988
TN
207P00000X
Emergency Medicine Physician
DO1988
TN
207Q00000X
Family Medicine Physician
0102202256
VA
207Q00000X
Family Medicine Physician
1988
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538352604
—
VA
01
—
3714470
GROUP MEDICARE
TN
01
—
621052914073
TRICARE
TN
Enumeration date
08/22/2007
Last updated
04/07/2023
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