Individual
PHILLIP D. ROSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1808 SHERMAN DR, PRINCETON, IN 47670-1043
(812) 385-9420
Mailing address
1808 SHERMAN DR, PRINCETON, IN 47670-1043
(812) 385-9420
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01075572A
IN
174400000X
Specialist
036058234
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0175572A
INDIANA STATE LICENSE
IN
05
—
036058234
—
IL
05
—
201308930
—
IN
01
—
940920014
MEDICARE PTAN
IN
Enumeration date
08/04/2006
Last updated
01/25/2016
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