Provider Demographics
NPI:1508165960
Name:HO, PHILIP WING-THAI (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:WING-THAI
Last Name:HO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:77 W FOREST AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1482
Mailing Address - Country:US
Mailing Address - Phone:928-773-2515
Mailing Address - Fax:928-225-3704
Practice Address - Street 1:77 W FOREST AVE STE 101
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1482
Practice Address - Country:US
Practice Address - Phone:928-773-2515
Practice Address - Fax:928-225-3704
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ467392085R0202X
TXQ93752085R0202X
CAA1457872085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology