Individual
GREGORY PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2508 BERT KOUNS LOOP, SUITE 201, SHREVEPORT, LA 71118-3133
(318) 212-5790
Mailing address
2508 BERT KOUNS LOOP, SUITE 201, SHREVEPORT, LA 71118-3133
(318) 212-5790
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
202632
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1078964
—
LA
Enumeration date
05/24/2007
Last updated
01/28/2011
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