Provider Demographics
NPI:1437835618
Name:FORBES, PHILLIP FRANCIS (PA-C)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:FRANCIS
Last Name:FORBES
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1412 FAIRMOUNT AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2908
Mailing Address - Country:US
Mailing Address - Phone:215-684-5344
Mailing Address - Fax:215-232-4093
Practice Address - Street 1:1412 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-2908
Practice Address - Country:US
Practice Address - Phone:215-235-9600
Practice Address - Fax:215-684-5360
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
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Provider Licenses
StateLicense IDTaxonomies
PAMA064563363A00000X
PAOA006503363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant