Individual
THOMAS PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97 S 4TH ST, STE D, ISHPEMING, MI 49849-2168
(906) 485-2102
(906) 486-6898
Mailing address
97 S 4TH ST, STE D, ISHPEMING, MI 49849-2168
(906) 485-2102
(906) 486-6898
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301045204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00187621
RRMEDICARE
MI
01
—
TP045204
BCBS LICENSE
MI
Enumeration date
12/13/2006
Last updated
07/08/2007
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