Provider Demographics
NPI:1710288188
Name:F. LEIGH PHILLIPS, III, MD, PA
Entity Type:Organization
Organization Name:F. LEIGH PHILLIPS, III, MD, PA
Other - Org Name:NONE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:954-344-4344
Mailing Address - Street 1:2855 N UNIVERSITY DR
Mailing Address - Street 2:400
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1405
Mailing Address - Country:US
Mailing Address - Phone:954-344-4344
Mailing Address - Fax:954-344-3781
Practice Address - Street 1:2855 N UNIVERSITY DR
Practice Address - Street 2:400
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1405
Practice Address - Country:US
Practice Address - Phone:954-344-4344
Practice Address - Fax:954-344-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058293174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty