Provider Demographics
NPI:1891756128
Name:MULLER, PHILIP JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:JOSEPH
Last Name:MULLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 4TH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1750
Mailing Address - Country:US
Mailing Address - Phone:712-234-0220
Mailing Address - Fax:712-234-0225
Practice Address - Street 1:600 4TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1750
Practice Address - Country:US
Practice Address - Phone:712-234-0220
Practice Address - Fax:712-234-0225
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA030992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4157164Medicaid
IAI13104Medicare PIN
IAG50385Medicare UPIN