Provider Demographics
NPI:1629892435
Name:PHILLIPS, WILLIAM COLLIER
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:COLLIER
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 UNION AVENUE ROOM 325
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-3514
Mailing Address - Country:US
Mailing Address - Phone:662-832-6963
Mailing Address - Fax:
Practice Address - Street 1:874 UNION AVENUE ROOM 325
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-3514
Practice Address - Country:US
Practice Address - Phone:662-832-6963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program