Provider Demographics
NPI:1659497311
Name:PHILLIPS, MICHAL MARANTO (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:MARANTO
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERCY WAY STE 20
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3000
Mailing Address - Country:US
Mailing Address - Phone:479-802-5555
Mailing Address - Fax:479-876-2829
Practice Address - Street 1:1 MERCY WAY STE 20
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-3000
Practice Address - Country:US
Practice Address - Phone:479-802-5555
Practice Address - Fax:479-876-2829
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM4446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine