Provider Demographics
NPI:1558561977
Name:PEPPLE, PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:PEPPLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 S DOBSON RD STE 115
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5600
Mailing Address - Country:US
Mailing Address - Phone:480-245-4425
Mailing Address - Fax:480-245-4426
Practice Address - Street 1:485 S DOBSON RD STE 115
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5600
Practice Address - Country:US
Practice Address - Phone:480-245-4425
Practice Address - Fax:480-245-4426
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141159390200000X
AZ54230208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program