Provider Demographics
NPI:1710286687
Name:PHILLIPS, BARBARA HAZELBAKER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:HAZELBAKER
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5431
Mailing Address - Country:US
Mailing Address - Phone:985-641-3847
Mailing Address - Fax:985-639-9835
Practice Address - Street 1:2090 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5431
Practice Address - Country:US
Practice Address - Phone:985-641-3847
Practice Address - Fax:985-639-9835
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist