Provider Demographics
NPI:1609966605
Name:PHILLIPS, STEPHEN THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:THOMAS
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-0428
Mailing Address - Country:US
Mailing Address - Phone:205-664-5111
Mailing Address - Fax:205-664-4071
Practice Address - Street 1:1960 CHANDALAR DR STE E
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4323
Practice Address - Country:US
Practice Address - Phone:205-664-5111
Practice Address - Fax:205-664-4071
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU29412Medicare UPIN