Individual
WAYNE F PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 WALNUT STREET, SUITE 209, BOULDER, CO 80302-5753
(303) 440-4599
(303) 440-6133
Mailing address
2501 WALNUT STREET, SUITE 209, BOULDER, CO 80302-5753
(303) 440-4599
(303) 440-6133
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
26413
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01264134
—
CO
Enumeration date
08/09/2006
Last updated
04/13/2017
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