Provider Demographics
NPI:1922044718
Name:FLEXON, PHILLIP BILLINGS (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:BILLINGS
Last Name:FLEXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:925 N POINT PKWY
Mailing Address - Street 2:STE 130
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5210
Mailing Address - Country:US
Mailing Address - Phone:678-206-2589
Mailing Address - Fax:678-261-1713
Practice Address - Street 1:1365 ROCK QUARRY RD STE 300
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5024
Practice Address - Country:US
Practice Address - Phone:770-740-1860
Practice Address - Fax:678-347-2104
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031737207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E19912Medicare UPIN
E19912Medicare UPIN
GA000398769GMedicaid
01366073OtherAMERIGROUP
GA511I040043Medicare PIN
SCP00679510OtherRAILROAD MEDICARE
GA511I040043Medicare PIN
SCAA18019141Medicare PIN