Provider Demographics
NPI:1881692010
Name:PHILIPPI, WILLIAM E (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:PHILIPPI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-774-5795
Mailing Address - Fax:706-774-5792
Practice Address - Street 1:820 SAINT SEBASTIAN WAY STE 4-A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2643
Practice Address - Country:US
Practice Address - Phone:706-774-5995
Practice Address - Fax:706-774-5792
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0720802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E75561Medicare UPIN
0083161Medicare ID - Type Unspecified