Provider Demographics
NPI:1841396934
Name:DRS. PHILLIPS, TODD & TAYLOR PC
Entity Type:Organization
Organization Name:DRS. PHILLIPS, TODD & TAYLOR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-979-9480
Mailing Address - Street 1:2034 PATTON CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5770
Mailing Address - Country:US
Mailing Address - Phone:205-979-9480
Mailing Address - Fax:205-979-9756
Practice Address - Street 1:2034 PATTON CHAPEL RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-5770
Practice Address - Country:US
Practice Address - Phone:205-979-9480
Practice Address - Fax:205-979-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41151223X0400X
AL48181223X0400X
AL38981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty