Provider Demographics
NPI:1518367473
Name:PHILLIPS, JOEL KENT (PA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:KENT
Last Name:PHILLIPS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:3505 DULUTH PARK LN
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3201
Mailing Address - Country:US
Mailing Address - Phone:678-597-3180
Mailing Address - Fax:678-597-3181
Practice Address - Street 1:3505 DULUTH PARK LN
Practice Address - Street 2:SUITE 400
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3201
Practice Address - Country:US
Practice Address - Phone:678-597-3180
Practice Address - Fax:678-597-3181
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2016-04-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant