Individual
DR. PHILLIP ANTHONY SANDIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 BAPTIST MEMORIAL CIR STE 330, OXFORD, MS 38655-4477
(662) 767-4201
Mailing address
1211 S GLOSTER ST STE A, TUPELO, MS 38801-6548
(662) 767-4200
(662) 767-4204
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25801
MS
207X00000X
Orthopaedic Surgery Physician
Primary
T-2600
MS
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
10277685-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04526240
—
MS
Enumeration date
07/02/2012
Last updated
07/21/2020
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