Individual
CARL DOUGLAS PHILLIPS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
109 YORKTOWN DR STE A, ALEXANDRIA, LA 71303-3673
(318) 542-4288
(318) 704-6201
Mailing address
500 IDLEWOOD DR, ALEXANDRIA, LA 71303-3455
(337) 400-4683
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN115788-AP06562
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP06562
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2160648
—
LA
Enumeration date
08/24/2011
Last updated
04/05/2024
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