Provider Demographics
NPI:1023078300
Name:SHARP, PHILIP VANCE (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:VANCE
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:1775 ONE HEALING PLACE
Mailing Address - Street 2:TMHPP RADIATION ONCOLOGY SPECIALISTS
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-431-5255
Mailing Address - Fax:850-431-6039
Practice Address - Street 1:1775 ONE HEALING PLACE
Practice Address - Street 2:TMHPP RADIATION ONCOLOGY SPECIALISTS
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-431-5255
Practice Address - Fax:850-431-6039
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME849002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256697400Medicaid
FL61979Medicare PIN
FLG95341Medicare UPIN