Individual
BENITA L PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
501 LONG HOLLOW PIKE STE A, GOODLETTSVILLE, TN 37072-3448
(158) 660-9006
(615) 622-2447
Mailing address
501 LONG HOLLOW PIKE STE A, GOODLETTSVILLE, TN 37072-3448
(615) 866-0900
(615) 622-2447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2074
TN
207Q00000X
Family Medicine Physician
DO 810
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51516692
BLUE CROSS
AL
05
—
51516692
—
AL
Enumeration date
09/27/2005
Last updated
06/17/2020
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