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DR. JONATHAN WINSTON PHILLIPS M.D.
Sports Medicine >> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1205090974
Individual Registrant:DR. JONATHAN WINSTON PHILLIPS M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
335 CHESTNUT ST NORWOOD, NJ 07648-2001 US
Tel: 201-899-3560 Fax: --
Tel: 201-899-3560 Fax: --
Contact information for business:
7560 RED BUG LAKE RD OVIEDO, FL 32765-6591 US
Tel: 407-951-5833 Fax: --
Tel: 407-951-5833 Fax: --
Registration Information:
NPI: 1205090974
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 207QS0010X | Allopathic & Osteopathic Physicians Family Medicine Sports Medicine | FL | ME110737 |
| Y | 207QS0010X | Allopathic & Osteopathic Physicians Family Medicine | NJ | 25MA10397400 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
