Provider Demographics
NPI:1811941735
Name:PHILPOTT, DONALD M (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:PHILPOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 HOSPITAL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2495
Mailing Address - Country:US
Mailing Address - Phone:931-962-4040
Mailing Address - Fax:931-962-2277
Practice Address - Street 1:155 HOSPITAL RD
Practice Address - Street 2:SUITE B
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2495
Practice Address - Country:US
Practice Address - Phone:931-962-4040
Practice Address - Fax:931-962-2277
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD28381208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3806467Medicaid
TN3118091OtherBCBS PROVIDER NUMBER
TN3806467Medicaid
TNG37727Medicare UPIN