Individual
BENJAMIN PHILLIPS IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2015 NW 19TH ST, OKLAHOMA CITY, OK 73106-1605
(405) 474-3162
Mailing address
2015 NW 19TH ST, OKLAHOMA CITY, OK 73106-1605
(405) 474-3162
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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