Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 9901287 | NC |
N | 208600000X | Surgeon | 9901287 | NC |
Y | 2086S0120X | Pediatric Surgery | 9901287 | NC |
NPI | 1376636548 |
---|---|
Provider Name | J Duncan Phillips |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891222G | (05) | NC |
G08234 | (02) | NC |