Provider Demographics
NPI:1164283305
Name:PHIPPS, SYDNEY (PA-C)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2008
Mailing Address - Country:US
Mailing Address - Phone:248-231-6325
Mailing Address - Fax:
Practice Address - Street 1:703 ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2008
Practice Address - Country:US
Practice Address - Phone:248-231-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant