NPIMap

Organization Active NPI

Mark B Phillips M.D., P.a.

  • Anesthesiology Physician
  • Jacksonville, FL
National Provider Identifier
1003997271
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME0047040 Issued in FL
Legal business name
MARK B PHILLIPS M.D., P.A.
Practice address
4545 Emerson Expressway
Jacksonville, FL 32207
Phone
(904) 399-2600
NPI assigned
Oct 17, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mark Phillip, M.D.
Title
President
Phone
(904) 396-5558

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X ME0047040 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

4545 Emerson Expressway
Jacksonville, FL 32207

Mailing address

PO Box 10543
Jacksonville, FL 32247-0543
Phone (904) 396-5558

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003997271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10543",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322470543",
            "telephone_number": "904-396-5558",
            "fax_number": "904-396-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 EMERSON EXPRESSWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-399-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK B PHILLIPS M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIP",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-396-5558",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME0047040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.