Provider Demographics
NPI:1245416049
Name:PHILLIPS & COMPANY, INC
Entity Type:Organization
Organization Name:PHILLIPS & COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-815-1960
Mailing Address - Street 1:PO BOX 13250
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:WA
Mailing Address - Zip Code:98013-0250
Mailing Address - Country:US
Mailing Address - Phone:303-815-1960
Mailing Address - Fax:303-889-5161
Practice Address - Street 1:730 17TH ST
Practice Address - Street 2:SUITE 915
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-3580
Practice Address - Country:US
Practice Address - Phone:303-815-1960
Practice Address - Fax:303-889-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1376514406OtherINDIVIDUAL NPI
CO78133718Medicaid
CO78133718Medicaid
COE74381Medicare UPIN