Provider Demographics
NPI:1689779001
Name:PHILLIPS, BARBIE DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:BARBIE
Middle Name:DAWN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2942
Mailing Address - Country:US
Mailing Address - Phone:580-256-7123
Mailing Address - Fax:580-256-1209
Practice Address - Street 1:1903 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2942
Practice Address - Country:US
Practice Address - Phone:580-256-7123
Practice Address - Fax:580-256-1209
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK500522053Medicare PIN