Individual
DR. MICHELLE NICOLE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3150 E HERITAGE PKWY, FARMINGTON, AR 72730-5529
(479) 400-1140
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MA10164900
NJ
208000000X
Pediatrics Physician
Primary
E-10842
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200069656
—
MO
05
—
200775380A
—
OK
05
—
224759001
—
AR
Enumeration date
07/03/2017
Last updated
04/07/2025
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