Phillips, Amanda Ruth

Phillips, Amanda Ruth is an sole proprietor health care provider with primary practice located at 2390 W Congress St , Lafayette LA 70506-4205. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Phillips, Amanda Ruth can be contacted via phone (337) 261-6010.

Contact Information

Primary practice address
2390 W Congress St Lafayette LA 70506-4205
Phone: (337) 261-6010
Fax: (337) 261-6153
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 025853 Louisiana

Profile Details

NPI number 1962474064
LBN Legal business name Phillips, Amanda Ruth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2006
Last updated Jul 14th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962474064 NPPES
Louisiana MEDICAID 1042811

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