Phillips, Kenneth Dean

Phillips, Kenneth Dean is an sole proprietor health care provider with primary practice located at 8 Doctors Park , Cape Girardeau MO 63703-4928. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Phillips, Kenneth Dean can be contacted via phone (573) 651-1333.

Contact Information

Primary practice address
8 Doctors Park Cape Girardeau MO 63703-4928
Phone: (573) 651-1333
Fax: (573) 651-1324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 106690 Missouri

Profile Details

NPI number 1053383281
LBN Legal business name Phillips, Kenneth Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2006
Last updated Mar 29th, 2021 - about 4 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 1053383281 NPPES
Missouri MEDICAID 207656638

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