Organization
KIMBERLY YOUNG PHILLIPS, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY YOUNG PHILLIPS MD (OWNER, PRESIDENT)
(706) 485-1145
Entity
Organization
Contact information
Practice address
142 HOSPITAL PERIMETER RD, EATONTON, GA 31024-8502
(706) 485-1145
(706) 485-6025
Mailing address
142 HOSPITAL PERIMETER RD, EATONTON, GA 31024-8502
(706) 485-1145
(706) 485-6025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051711
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051711
LICENSE
GA
01
—
893856
BLUE CROSS BLUE SHIELD
GA
01
—
DE8801
RAILROAD MEDICARE
GA
Enumeration date
08/07/2006
Last updated
05/14/2008
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