Provider Demographics
NPI:1598108193
Name:PHILLPOTTS, DENIS (MD)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:PHILLPOTTS
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 1:16091 BLATT BLVD
Mailing Address - Street 2:APT 107
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1439
Mailing Address - Country:US
Mailing Address - Phone:954-389-7995
Mailing Address - Fax:
Practice Address - Street 1:16091 BLATT BLVD
Practice Address - Street 2:APT 107
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1439
Practice Address - Country:US
Practice Address - Phone:954-389-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 23200207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology