Individual
PHILLIP R KINGMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12289 HANCOCK ST STE 34, CARMEL, IN 46032-5888
(317) 815-8950
(317) 815-8951
Mailing address
12289 HANCOCK ST STE 34, CARMEL, IN 46032-5888
(317) 815-8950
(317) 815-8951
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
01040487
IN
Other
Enumeration date
03/24/2006
Last updated
10/21/2022
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