Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD008603 | LA |
NPI | 1003231440 |
---|---|
Provider Name | Stuart Ivor Phillips |
First Address | New Orleans, LA 70115-3125 |
Second Address | New Orleans, LA 70115-3125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2014 |
Last Update Date | 21/02/2014 |