Provider Demographics
NPI:1609949569
Name:PHILLIPS, KORRI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:KORRI
Middle Name:LYNN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KORRI
Other - Middle Name:LYNN
Other - Last Name:NAPIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1516 SW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1696
Mailing Address - Country:US
Mailing Address - Phone:852-700-0477
Mailing Address - Fax:
Practice Address - Street 1:1516 SW 6TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1696
Practice Address - Country:US
Practice Address - Phone:785-270-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100317560CMedicaid
080192113OtherRAILROAD
KS100317560CMedicaid
KS068002008Medicare PIN