Individual
DR. THEODORE L. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2701 E ELVIRA RD, TUCSON, AZ 85756-7124
(520) 874-4024
Mailing address
1635 DIVISADERO STREET, SUITE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A19551
CA
2085R0202X
Diagnostic Radiology Physician
A19551
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A195510
—
CA
Enumeration date
06/12/2006
Last updated
02/07/2012
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