Individual
MARK T PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 22ND AVE, MEDICAL TOWERS III, 3RD FLOOR, MERIDIAN, MS 39301-3223
(601) 693-1055
(601) 482-5312
Mailing address
PO BOX 749215, ATLANTA, GA 30374-9215
(901) 226-3186
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
11068
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110336
—
MS
Enumeration date
02/26/2007
Last updated
10/24/2024
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