Provider Demographics
NPI:1497793764
Name:PHILLIPS, STEVEN LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LYNN
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W WILLOW RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-2511
Mailing Address - Country:US
Mailing Address - Phone:580-242-3003
Mailing Address - Fax:580-233-3279
Practice Address - Street 1:305 S 5TH ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5832
Practice Address - Country:US
Practice Address - Phone:580-233-6100
Practice Address - Fax:580-249-3826
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1982207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology