Provider Demographics
NPI:1033319124
Name:PHILLIPS, GREGORY M (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:M
Last Name:PHILLIPS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:74B CENTENNIAL LOOP STE 300
Mailing Address - Street 2:NEUROSPINE INSTITUTE LLC
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7925
Mailing Address - Country:US
Mailing Address - Phone:541-393-0100
Mailing Address - Fax:541-393-0104
Practice Address - Street 1:74B CENTENNIAL LOOP STE 300
Practice Address - Street 2:NEUROSPINE INSTITUTE LLC
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7925
Practice Address - Country:US
Practice Address - Phone:541-393-0100
Practice Address - Fax:541-393-0104
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2022-06-20
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Provider Licenses
StateLicense IDTaxonomies
OR278872081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1035319124Medicare PIN
ORI39391Medicare UPIN