Provider Demographics
NPI:1144617358
Name:PHILIP, JAMES (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:PHILIP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-2300
Mailing Address - Country:US
Mailing Address - Phone:814-342-9701
Mailing Address - Fax:814-342-7056
Practice Address - Street 1:271 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866
Practice Address - Country:US
Practice Address - Phone:814-342-9701
Practice Address - Fax:814-342-7056
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-26
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9708207Q00000X, 208D00000X
TX592181390200000X
PAOS019637207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program