DR. MARK C PHILLIPS (NPI# 1275568735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275568735 |
Entity Type | Individual |
Full Name | DR. MARK C PHILLIPS |
Other Name | MARK C PHILLIPS |
Credential | MD |
Practice Address |
860 N Myrtle Rd Myrtle Creek OR 97457-9626 |
Practice Telephone | 5418633410 |
Practice Fax Number | 5418636435 |
Mailing Telephone | 5418633410 |
Mailing Fax Number | 5418636435 |
Enumeration Date | 2006-07-12 |
Last Update Date | 2015-10-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 173000000X | Legal Medicine | MD18731 | OR | Other Service Providers |
Y | 208D00000X | General Practice | MD18731 | OR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | STATE LICENSE # | MD18731 | 01 |
OR | 065586 | 05 | |
OR | OR DEA # | BP1202011 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033697073 | Mark Phillips | Naturopath | 1170 N Gilbert Rd Ste 15, Gilbert, AZ 85234-2340 | 2018-08-01 |
1639699663 | Mark W. Phillips | Nurse Practitioner | 1 S School Ave Ste 200, Sarasota, FL 34237 | 2017-06-21 |
1225589328 | Mark Phillips | Counselor | 200 Century Park S Ste 116, Birmingham, AL 35226-3923 | 2016-10-24 |
1619293735 | Mark A Phillips | Social Worker | 65 Technology Way Ste 1e3, Nashua, NH 03060 | 2010-04-14 |
1245403211 | Mark Terrance Phillips | Dentist | 4024 8th Ln, Anoka, MN 55303-1251 | 2008-04-10 |
1598704256 | Mark D. Phillips | Dentist | 311 N Breiel Blvd, Middletown, OH 45042-3868 | 2006-06-06 |
1548212863 | Mark J Phillips | Family Medicine | 3627 Webber St, Suite A, Sarasota, FL 34232-4412 | 2006-05-16 |
1558336297 | Mark Lynn Phillips | Specialist | 1 Raider Circle, Northbrook High School, Houston, TX 77080 | 2006-02-17 |
1275511966 | Mark Lucas Phillips | Pain Medicine | 522 N Elam Ave, Ste 203, Greensboro, NC 27403-1151 | 2006-01-04 |
1366441644 | Mark R Phillips | Orthopaedic Surgery | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2005-07-19 |
Street Address |
860 N MYRTLE RD |
City | MYRTLE CREEK |
State | OR |
Zip Code | 97457-9626 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629542626 | Reva Jeanne Whitson | Massage Therapist | 837 N Main St., Myrtle Creek, OR 97457 | 2019-01-14 |
1235619578 | Mark Francis Kleinschmidt | Massage Therapist | 213 S.pacific Hwy., St. 101, Myrtle Creek, OR 97457 | 2018-08-16 |
1992183859 | Centennial Medical Group East, LLC | Clinic/Center | 145 E. Broadway, Myrtle Creek, OR 97457 | 2015-05-12 |
1356504443 | Jd Tucker Rohm | Chiropractor | 213 So. Old Pacific Highway, Suite 101, Myrtle Creek, OR 97457 | 2008-07-08 |
1295998920 | Paula Jo Cramer | Nurse Practitioner | 790 S Main St Myrtle, Creek, Ore, Myrtle Creek, OR 97457 | 2008-07-02 |
1952529810 | Jackie J Sochin | Nurse Practitioner | 790 S. Main, Myrtle Creek, OR 97457 | 2007-04-23 |
1255480786 | James A. Lawson Jr. | Dentist | 434 N. E. 2nd St., Myrtle Creek, OR 97457 | 2007-01-10 |
1194809921 | Kenneth Lee Mills | Dentist | 244 Ne Division, Myrtle Creek, OR 97457 | 2006-10-25 |
1164516365 | Jaime Francisco Serranzana | General Practice | 925 Nw Pacific Hwy, Myrtle Creek, OR 97457 | 2006-10-03 |
1407968472 | Lynn E Goodwin | Optometrist | 425 N Main, Myrtle Creek, OR 97457 | 2006-08-31 |
Find all providers in zip 97457 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164516365 | Jaime Francisco Serranzana | General Practice | 925 Nw Pacific Hwy, Myrtle Creek, OR 97457 | 2006-10-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285234674 | Sme Hawaii PC Inc | General Practice | 6021 Se Heike St, Hillsboro, OR 97123-8296 | 2020-10-27 |
1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
1801333901 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3175 Nw Aloclek Dr, Hillsboro, OR 97124-7135 | 2017-01-26 |
1336697143 | Rita Lawler | General Practice | 8353 Se Clatsop Ct, Portland, OR 97266-6159 | 2016-09-21 |
1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
1659730760 | Propel Network, LLC | General Practice | 14525 Sw Millikan Way, Beaverton, OR 97005-2343 | 2016-02-17 |
1235526849 | Hollis Lule Augee | General Practice | 5151 S.w. 88th Ave., Portland, OR 97225-1717 | 2015-04-21 |
1023428034 | Victoria L. Larson | General Practice | 10,000 Se 222nd Ave., Damascus, OR 97089-6517 | 2014-04-29 |
1093134496 | Red Leaf Natural Health Clinic | General Practice | 833 Sw 11th Ave Ste 1018, Portland, OR 97205-2124 | 2014-04-14 |
Find all providers with the same taxonomy |
City | MYRTLE CREEK |
Zip Code | 97457 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.