Individual
ROBERT E PHILLIPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
207 S MAIN ST, BERRYVILLE, AR 72616-3921
(870) 423-4949
(870) 423-4754
Mailing address
PO BOX 557, BERRYVILLE, AR 72616-0557
(870) 423-4949
(870) 423-4754
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C01009
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129076701
—
AR
01
—
5S537
BCBS
AR
05
—
918392309
—
MO
01
—
P00082511
RAILROAD MEDICARE
—
Enumeration date
05/05/2006
Last updated
05/19/2008
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