Provider Demographics
NPI:1700846078
Name:PHILLIPS, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HOSPITAL DRIVE
Mailing Address - Street 2:HOSP HILL MED CENTER
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3027
Mailing Address - Country:US
Mailing Address - Phone:540-347-0505
Mailing Address - Fax:540-347-5224
Practice Address - Street 1:550 HOSPITAL DRIVE
Practice Address - Street 2:HOSP HILL MED CENTER
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3027
Practice Address - Country:US
Practice Address - Phone:540-347-0505
Practice Address - Fax:540-347-5224
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232269207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006306446Medicaid
G51920Medicare UPIN
VA040000512Medicare ID - Type Unspecified