Provider Demographics
NPI:1801957865
Name:PHILLIPS, JEFFERY H (MD PHD FACS)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:H
Last Name:PHILLIPS
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Gender:M
Credentials:MD PHD FACS
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Mailing Address - Street 1:9400 LIVINGSTON ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744
Mailing Address - Country:US
Mailing Address - Phone:301-248-2100
Mailing Address - Fax:301-248-2182
Practice Address - Street 1:9400 LIVINGSTON ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744
Practice Address - Country:US
Practice Address - Phone:301-248-2100
Practice Address - Fax:301-248-6624
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDD21596207X00000X
VA0101029702207X00000X
DCMD11000207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery