Individual
STANLEY J PHILLIPS
Active
Individual
STANLEY J PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
27973660501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005819102
MEDICARE PIN FOR FOOT & ANKLE CLINIC
UT
05
—
203620216001
—
UT
Enumeration date
08/13/2006
Last updated
02/09/2021
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