Williford, Phillip Mabon

Williford, Phillip Mabon is an individual health care provider with primary practice located at 4618 Country Club Rd , Winston Salem NC 27104-3520. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Williford, Phillip Mabon can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
4618 Country Club Rd Winston Salem NC 27104-3520
Phone: (336) 716-2255
Fax: (336) 716-6761
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 26483 North Carolina
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 26483 North Carolina

Profile Details

NPI number 1518943943
LBN Legal business name Williford, Phillip Mabon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Nov 15th, 2010 - about 14 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 1518943943 NPPES
Other 88074 BCBS
Other 5552 BCBS
MEDICAID 5940478 BCBS
MEDICAID N26483 BCBS
MEDICAID 2005036000 BCBS
Other 4671710 BCBS
Other 70016802 BCBS
MEDICAID 8988074 BCBS
Other 64002 BCBS

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