Provider Demographics
NPI:1821301409
Name:PHILLIPS, ADAM N (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:N
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4759 LAKEVIEW DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2005
Mailing Address - Country:US
Mailing Address - Phone:863-402-5600
Mailing Address - Fax:863-402-5602
Practice Address - Street 1:8029 COOPER CREEK BLVD STE 104
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-3003
Practice Address - Country:US
Practice Address - Phone:800-991-6117
Practice Address - Fax:888-812-8191
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2023-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS14066208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4785778OtherAETNA
FLQHWKCOtherBLUE CROSS BLUE SHIELD OF FLORIDA