Provider Demographics
NPI:1982727590
Name:BENNION, PHILLIP WASHBURN (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:WASHBURN
Last Name:BENNION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2122 E HIGHLAND AVE
Mailing Address - Street 2:SUITE300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4739
Mailing Address - Country:US
Mailing Address - Phone:602-553-3113
Mailing Address - Fax:602-667-7991
Practice Address - Street 1:2122 E HIGHLAND AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4739
Practice Address - Country:US
Practice Address - Phone:602-553-3113
Practice Address - Fax:602-667-7991
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40310207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery