Individual
RUTHANN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
758 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3385
(770) 962-4300
(770) 339-7544
Mailing address
758 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3385
(770) 962-4300
(770) 339-7544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001106
GA
363AS0400X
Surgical Physician Assistant
001106
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000301914C
—
GA
Enumeration date
07/07/2005
Last updated
11/11/2013
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