Individual
DR. JUSTIN WESLEY PHILLPOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2055 NORMANDIE DR, 108, MONTGOMERY, AL 36111-2732
(334) 288-4624
(334) 280-3628
Mailing address
2055 NORMANDIE DR, 108, MONTGOMERY, AL 36111-2732
(334) 288-4624
(334) 280-3628
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
00026333
AL
2085R0202X
Diagnostic Radiology Physician
053805
GA
2085R0202X
Diagnostic Radiology Physician
J8715
TX
2085R0202X
Diagnostic Radiology Physician
Primary
ME76550
FL
2085R0204X
Vascular & Interventional Radiology Physician
00026333
AL
2085R0204X
Vascular & Interventional Radiology Physician
053805
GA
2085R0204X
Vascular & Interventional Radiology Physician
J8715
TX
2085R0204X
Vascular & Interventional Radiology Physician
ME76550
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107041
—
AL
05
—
107043
—
AL
05
—
108074
—
AL
05
—
108373
—
AL
Enumeration date
02/06/2006
Last updated
11/02/2011
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