Philip D Doolittle, MD
Individual provider Active NPI Surgery Physician · Greenville, MS
NPI 1104925148 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104925148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 06401 (MS)
- Practice address
- 1214 Hospital St
Greenville, MS 38703-3213 - Phone
- (662) 335-9283
- Fax
- (662) 334-6989
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091130000160 | MS | Practitioner - General Surgery | 5597804898 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenville Surgical Clinic | Surgery | Current |
Accepting new patients |
| Renia R Dotson MD PC | Past | Accepting new patients |
Locations
1214 Hospital St
Greenville, MS 38703
Phone (601) 335-9283
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6af660a6-1deb-4c41-a9ac-8c8750f37b1d/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 06401 | MS | Yes |
Addresses
Primary practice location
1214 Hospital St
Greenville, MS 38703-3213
Mailing address
1623 Anne Stokes Rd
Greenville, MS 38701-6908
Phone (662) 378-9715
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00115158 | Medicaid | MS |
Other providers in Greenville, MS
- Betty Taylor Dixon
- Dominick Trinca, M.D. PA
- Deborah A Domino
- Carol Cashion Doolittle
- Jeffery Samuel Doolittle
- Sandra Dorman
- Harry L Dorsey
- Renia R Dotson
- Douglas E Fleming LLC
- David Grant Dowdy
All providers in Greenville, MS · Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.