Individual
KEVIN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
802 NW SHERIDAN RD, LAWTON, OK 73505-5296
(580) 713-7160
(580) 713-7163
Mailing address
802 NW SHERIDAN RD, LAWTON, OK 73505-5296
(580) 713-7160
(580) 713-7163
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12349
OK
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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