Individual
TERRELL R PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
401 SW 80TH ST, BLDG D STE 200, OKLAHOMA CITY, OK 73139-8122
(405) 601-4227
(405) 601-4237
Mailing address
PO BOX 357, LOWELL, AR 72745-0357
(405) 775-9350
(405) 775-9360
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2427
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050020190
MEDICARE RR
OK
01
—
050031732
MEDICARE RR
OK
05
—
100089860A
—
OK
Enumeration date
06/09/2006
Last updated
11/11/2020
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