Individual
JACLINE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 NACOOCHEE AVE, ATHENS, GA 30601-1823
(706) 381-7781
Mailing address
150 NACOOCHEE AVE, ATHENS, GA 30601-1823
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
100833
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2019
Last updated
07/16/2024
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