Provider Demographics
NPI:1295319234
Name:WARREN H. PHILLIPS, III, PHD PC
Entity type:Organization
Organization Name:WARREN H. PHILLIPS, III, PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:H
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:515-233-1122
Mailing Address - Street 1:223 S WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6974
Mailing Address - Country:US
Mailing Address - Phone:515-233-1122
Mailing Address - Fax:
Practice Address - Street 1:223 S WALNUT AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6974
Practice Address - Country:US
Practice Address - Phone:515-233-1122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WARREN H. PHILLIPS, III, PHD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty