Individual
THEODORE GEORGE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 S CEDAR CREST BLVD, SUITE 310, ALLENTOWN, PA 18103-6224
(610) 402-6890
(610) 402-6892
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD041580L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000637659
KEYSTONE EAST
PA
05
—
0012385870005
—
PA
01
—
0467898000
AMERIHEALTH (IBC)
PA
01
—
1511814
GATEWAY HEALTH PLAN
PA
01
—
20034834
AMERIHEALTH MERCY
PA
01
—
30022212
KEYSTONE MERCY
PA
01
—
35920
GEISINGER HEALTH PLAN
PA
01
—
3641356
AETNA
PA
01
—
50039540
CAPITAL BLUE CROSS
PA
01
—
637659
HIGHMARK BLUE SHIELD
PA
01
—
P00192724
RAILROAD MEDICARE
PA
Enumeration date
05/15/2006
Last updated
11/25/2015
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