Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 20192 | TN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 20192 | TN |
NPI | 1023075611 |
---|---|
Provider Name | Dr. Owen P. Phillips |
First Address | Memphis, TN 38103-2807 |
Second Address | Memphis, TN 38120-2382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 28/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3050806 | (05) | TN |
B65023 | (02) |