Individual
DR. KASSANDRA JANE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2937 FOX CHASE LN, MIDLOTHIAN, VA 23112-4400
(804) 372-3473
Mailing address
2937 FOX CHASE LN, MIDLOTHIAN, VA 23112-4400
(804) 372-3473
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0102206067
VA
2080I0007X
Pediatric Clinical & Laboratory Immunology Physician
2271
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810015268
—
WV
Enumeration date
06/22/2007
Last updated
10/29/2020
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