Individual
DR. AMANDA RUTH PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6010
(337) 261-6153
Mailing address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6010
(337) 261-6153
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
025853
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1042811
—
LA
Enumeration date
02/02/2006
Last updated
07/14/2022
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