Provider Demographics
NPI:1558610618
Name:PHIPPS, ROY ALLEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:ALLEN
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 RINGGOLD ROAD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-1640
Mailing Address - Country:US
Mailing Address - Phone:423-629-1434
Mailing Address - Fax:423-629-9646
Practice Address - Street 1:3824 RINGGOLD ROAD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-1640
Practice Address - Country:US
Practice Address - Phone:423-629-1434
Practice Address - Fax:423-629-9646
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist