Individual
ETHAN MICHAEL PHILPOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2255 N. SCOTTSDALE ROAD, SCOTTSDALE, AZ 85257
(480) 464-8000
(480) 990-2556
Mailing address
2255 N. SCOTTSDALE ROAD, SCOTTSDALE, AZ 85257
(480) 464-8000
(480) 990-2556
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036127162
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074755
GA MEDICAL LICENSE
GA
Enumeration date
10/03/2006
Last updated
02/19/2019
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