Provider Demographics
NPI:1699826990
Name:PHILLIPS, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1026 GOODYEAR AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1102
Mailing Address - Country:US
Mailing Address - Phone:256-543-3977
Mailing Address - Fax:256-543-1339
Practice Address - Street 1:1026 GOODYEAR AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1102
Practice Address - Country:US
Practice Address - Phone:256-543-3977
Practice Address - Fax:256-543-1339
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL7400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51030963OtherBCBS OF AL
AL000030963Medicaid
AL000030963Medicare ID - Type Unspecified
ALC74953Medicare UPIN