Provider Demographics
NPI:1720341779
Name:PHILLIPS, JULIA KATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:KATHRYN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD STE 1017B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8264
Mailing Address - Country:US
Mailing Address - Phone:314-292-7080
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD STE 1017B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8264
Practice Address - Country:US
Practice Address - Phone:314-292-7080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-23
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012020341207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology