Individual
DR. TERRY M PHILLIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 LEIGHTON AVE, ANNISTON, AL 36207
(256) 237-6717
(256) 237-6717
Mailing address
PO BOX 428, 622 LEIGHTON AVE, ANNISTON, AL 36207
(256) 237-6717
(256) 236-1920
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
21542
AL
208800000X
Urology Physician
Primary
21542
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000076321
—
AL
01
—
051076321
BLUE CROSS AND BLUE SHIEL
AL
Enumeration date
03/10/2006
Last updated
03/24/2010
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