Individual
DR. JAMES T PHILLIPS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
209 24TH ST E, TIFTON, GA 31794-3170
(229) 382-0467
(229) 382-8714
Mailing address
PO BOX 1295, TIFTON, GA 31793-1295
(229) 382-0467
(229) 382-8714
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO11260
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00622421
—
GA
05
—
101598
—
GA
01
—
724756
724756
GA
01
—
910231
BCBS
GA
05
—
9184127
—
GA
Enumeration date
11/06/2006
Last updated
09/12/2008
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