Phillips, John Keith

Phillips, John Keith is an individual health care provider with primary practice located at 4080 Lafayette Center Dr Suite 170, Chantilly VA 20151-1247. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Phillips, John Keith can be contacted via phone (703) 766-5040.

Contact Information

Primary practice address
4080 Lafayette Center Dr Suite 170 Chantilly VA 20151-1247
Phone: (703) 766-5040
Fax: (703) 766-5047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101231142 Virginia

Profile Details

NPI number 1699760371
LBN Legal business name Phillips, John Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Apr 17th, 2012 - about 13 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 1699760371 NPPES
Virginia MEDICAID 05647398
Virginia Other P00015942

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