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Individual

DR. CYNTHIA L. PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-6051
Mailing address
907 18TH ST E, SUITE 150, TIFTON, GA 31794-3643
(229) 353-6051

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048700
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000866742C
GA
01
197971
BLUE SHIELD OF GA
GA
Enumeration date
06/23/2006
Last updated
12/01/2020
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