Douglas Leon Phillips II, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001562 Issued in IN

Practice address

8607 Temple Dr
Fort Wayne, IN 46809-3048

Phone

(260) 478-9220

Fax

(260) 478-9172

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associated Family Medical Consultants PC

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1265454755
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1477534998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 E DUPONT RD",
            "address_2": "SUITE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-373-9700",
            "fax_number": "260-458-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 TEMPLE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468093048",
            "telephone_number": "260-478-9220",
            "fax_number": "260-478-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DOUGLAS",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100362730",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Addison Danielle Phillippe
• Onna Phillippe, RBT
• Rene Michelle Phillippe, APRN, FNP-C,PMHNP-BC
• Milissa C. Phillips-Bohlender, NP
• Abby Phillips
• Heather Phillips, LMFT
• John R Phillips
• Kelly Phillips, BCBA
• Kiarra Phillips
• Randall Joseph Phillips, MD

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.