| Phillips Medicine Llc | |
|
1011 Sheridan Road Redfield AR 72132 | |
| (501) 397-2604 | |
| (501) 397-2645 |
| Full Name | Phillips Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1011 Sheridan Road, Redfield, Arkansas |
| Authorized Official Name and Position | Tracy Phillips (PHYSICIAN) |
| Authorized Official Contact | 5013972604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillips Medicine Llc Po Box 20146 White Hall AR 71612-0146 Ph: (501) 397-2604 | Phillips Medicine Llc 1011 Sheridan Road Redfield AR 72132 Ph: (501) 397-2604 |
| NPI Number | 1235653882 |
|---|---|
| Provider Enumeration Date | 07/26/2017 |
| Last Update Date | 02/28/2018 |
| Medicare PECOS PAC ID | 8325586605 |
|---|---|
| Medicare Enrollment ID | O20240817000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235653882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tracy Thomas Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679571863 PECOS PAC ID: 2163555319 Enrollment ID: I20100809000688 |
Jefferson Comprehensive Care System, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 W River Rd, Redfield, AR 72132 Phone: 501-397-2261 Fax: 501-397-2263 |