Provider Demographics
NPI:1477620896
Name:FOSHEE, PHILLIP DEWEY (MD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:DEWEY
Last Name:FOSHEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 PINEDALE RD.
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35045
Mailing Address - Country:US
Mailing Address - Phone:205-755-3877
Mailing Address - Fax:205-755-3608
Practice Address - Street 1:310 PINEDALE RD
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045
Practice Address - Country:US
Practice Address - Phone:205-755-3877
Practice Address - Fax:205-755-3608
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00003110208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice