Provider Demographics
NPI:1639312242
Name:PHILIP, GEORGE JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOHN
Last Name:PHILIP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:621 S NEW BALLAS RD STE 560A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8261
Mailing Address - Country:US
Mailing Address - Phone:314-251-6440
Mailing Address - Fax:314-251-4456
Practice Address - Street 1:621 S NEW BALLAS RD STE 560A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8261
Practice Address - Country:US
Practice Address - Phone:314-251-6440
Practice Address - Fax:314-251-4456
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2025-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI13239208600000X
OH35.127225208600000X
MO2025013256208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery