Provider Demographics
NPI:1548432289
Name:PHILLIPS, KIWITA S (MD)
Entity Type:Individual
Prefix:DR
First Name:KIWITA
Middle Name:S
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIWITA
Other - Middle Name:
Other - Last Name:PHILLIPS-ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:720 WESTVIEW DRIVE SW
Mailing Address - Street 2:HARRIS BLDG., 100-A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310
Mailing Address - Country:US
Mailing Address - Phone:404-756-1400
Mailing Address - Fax:
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 275
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-3098
Practice Address - Country:US
Practice Address - Phone:404-756-1290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64442207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology