Chandler Phillips, M.D.

Individual provider Active NPI Family Medicine Physician · Medway, OH

NPI 1023304151 · NPPES record last updated Jun 28, 2011

Key facts

NPI
1023304151
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
35.035867 (OH)
Practice address
10425 W Union Rd
Medway, OH 45341-9747
Phone
(937) 849-9277
Fax
(937) 849-9278
NPI assigned
Jun 28, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G18906CAMDFamily Medicine Physician
01024626AINMDFamily Medicine Physician
35.035867OHMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.035867 OH Yes
Family Medicine Physician 207Q00000X 01024626A IN
Family Medicine Physician 207Q00000X G18906 CA

Addresses

Primary practice location

10425 W Union Rd
Medway, OH 45341-9747

Mailing address

10425 W Union Rd
Medway, OH 45341-9747
Phone (937) 849-9277

Other identifiers

IdentifierTypeStateIssuer
8502258MedicaidOH

Other names

  • Prof. Chandler Philllips Other name

Other providers in Medway, OH

All providers in Medway, OH · Family Medicine Physician in Ohio

Sources for this page

Verify at the official NPI Registry.