| Blake Phillips D.m.d., P.c. | |
|
1112 19th St S Birmingham AL 35205-4814 | |
| (205) 933-1331 | |
| Not Available |
| Full Name | Blake Phillips D.m.d., P.c. |
|---|---|
| Speciality | Dentist |
| Location | 1112 19th St S, Birmingham, Alabama |
| Authorized Official Name and Position | Joseph Blake Phillips (ORAL AND MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 2059331332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Phillips D.m.d., P.c. 1112 19th St S Birmingham AL 35205-4814 Ph: () - | Blake Phillips D.m.d., P.c. 1112 19th St S Birmingham AL 35205-4814 Ph: (205) 933-1331 |
| NPI Number | 1881236883 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 11/14/2019 |
| Medicare PECOS PAC ID | 2365874633 |
|---|---|
| Medicare Enrollment ID | O20191107002856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881236883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Joseph B Phillips |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598183204 PECOS PAC ID: 0648602516 Enrollment ID: I20191119000696 |
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