Provider Demographics
NPI:1942488986
Name:JANE PHILLIPS SPECIALTY PHYSICIANS
Entity Type:Organization
Organization Name:JANE PHILLIPS SPECIALTY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-331-1090
Mailing Address - Street 1:PO BOX 1089
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74101-1089
Mailing Address - Country:US
Mailing Address - Phone:918-331-1090
Mailing Address - Fax:
Practice Address - Street 1:226 SE DEBELL AVE
Practice Address - Street 2:BLDG B
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2343
Practice Address - Country:US
Practice Address - Phone:918-331-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty