Provider Demographics
NPI:1528006319
Name:PHILIPP, JOSEPH THEODORE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THEODORE
Last Name:PHILIPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1104 WATERS ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-2830
Mailing Address - Country:US
Mailing Address - Phone:785-537-3400
Mailing Address - Fax:785-537-3404
Practice Address - Street 1:3630 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-3966
Practice Address - Country:US
Practice Address - Phone:785-273-8080
Practice Address - Fax:785-273-2583
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0415061207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00264737OtherRAILROAD MEDICARE
KS105122OtherBCBS
KSAP90001582OtherDEA
KSAP90001582OtherDEA
KSB68372Medicare UPIN