Individual
DR. PHILLIP J SUFFRIDGE
Active
Individual
DR. PHILLIP J SUFFRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E2274
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06040018300
QUALCHOICE
AR
05
—
161592001
—
AR
01
—
204462170
UNITED HEALTHCARE
AR
01
—
5N525
BLUE CROSS BLUE SHIELD
AR
01
—
P00445226
RAILROAD MEDICARE
AR
Enumeration date
04/11/2006
Last updated
09/30/2013
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