TRACY THOMAS PHILLIPS (NPI# 1679571863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679571863 |
| Entity Type | Individual |
| Full Name | TRACY THOMAS PHILLIPS |
| Credential | D.O. |
| Practice Address |
103 Frankie Ln White Hall AR 71602-2685 |
| Mailing Address |
Po Box 20146 White Hall AR 71612-0146 |
| Practice Telephone | 5013972604 |
| Practice Fax Number | 5013972645 |
| Mailing Telephone | 5013972604 |
| Mailing Fax Number | 5013972645 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2019-08-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | E1018 | AR | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | E-1018 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 129995003 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1808 W Main St, Russellville, AR 728012724 | 4799644178 | 4799645910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629245998 | Tracy Lynn Phillips | Licensed Practical Nurse | 5620 W Birch Harbor Dr, Wasilla, AK 99654-9430 | 2008-05-14 |
| 1558464990 | Tracy T Phillips | Obstetrics & Gynecology | 2089 Vale Road, Suite 10, San Pablo, CA 94806 | 2006-09-07 |
| 1619960408 | Tracy A Phillips | Optometrist | 336 El Camino Real, San Carlos, CA 94070-2408 | 2005-08-26 |
| 1770073702 | Tracy Lanae Phillips | Counselor | 525 Estudillo Ave, San Leandro, CA 94577-4684 | 2018-05-15 |
| 1508013293 | Tracy B Phillips | Optometrist | 1733 2nd St S, Meridian, MS 39301-4514 | 2008-08-25 |
| 1689873754 | Tracy Phillips | Counselor | 3707 Sunset Lane, Antioch, CA 94509 | 2007-07-17 |
| 1588876866 | Tracy Lee Phillips | Dentist | 8015 164th St, Jamaica, NY 11432-1116 | 2007-05-07 |
| 1578648309 | Tracy Elizabeth Phillips | Social Worker | 2795 Richmond Ave, Staten Island, NY 10314-5857 | 2006-10-27 |
| 1376527051 | Tracy B Phillips | Pediatrics | 258 Ne Tudor Rd, Lees Summit, MO 64086-5696 | 2005-12-06 |
| Street Address |
103 FRANKIE LN |
| City | WHITE HALL |
| State | AR |
| Zip Code | 71602-2685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134734049 | Primary Care 360 | Family Medicine | 103 Frankie Ln, White Hall, AR 71602-2685 | 2020-09-09 |
| 1356849046 | Raluca Tudoreanu | Nurse Practitioner | 103 Frankie Ln, White Hall, AR 71602-2685 | 2018-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265050447 | Bridget Furlong | Occupational Therapist | 2226 Barncy Lane, White Hall, AR 71602 | 2020-07-14 |
| 1609399963 | Interventional Surgery Institute of White Hall LLC | Clinic/Center | 7211 Dollarway Road, White Hall, AR 71602 | 2017-07-19 |
| 1679935761 | Pain Treatment Centers of America, Pllc | Durable Medical Equipment & Medical Supplies | 7211 Dollarway Rd, White Hall, AR 71602 | 2016-03-28 |
| 1326450446 | Rafeek Hegazy | Anesthesiology | 202 Frankie Ln, White Hall, AR 71602 | 2014-05-22 |
| 1275873515 | Craig Paul Anderson | Preventive Medicine | 13-020 Kabrich Circle, Pine Bluff, AR 71602 | 2013-02-24 |
| 1124258553 | Shellia Anne Kornegay | Nurse Practitioner | 1515 West 42nd Street, Pine Bluff, AR 71602 | 2009-07-20 |
| 1275789109 | Sarah Allison Rushing | Speech-Language Pathologist | 1020 West Holland Avenue, White Hall, AR 71602 | 2008-08-12 |
| 1245438852 | White Hall School District | Local Education Agency (LEA) | 1020 West Holland, White Hall, AR 71602 | 2007-07-05 |
| 1972622652 | Dewey Charles Scarbrough | Physician Assistant | 109 Frankie Lane, White Hall, AR 71602 | 2007-03-27 |
| 1427126135 | Donna D Massey | Dentist | 7215 Sheridan Road, White Hall, AR 71602 | 2006-12-01 |
| Find all providers in zip 71602 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780981498 | Tim Wilkin D.o., P.a. | Family Medicine | 8608 Dollarway Rd, Suite C, White Hall, AR 71602-2814 | 2011-02-15 |
| 1659585263 | Whitehall Medical Pllc | Family Medicine | 60 Roxbury Road, White Hall, WV 26554-3430 | 2007-05-10 |
| 1679794762 | Timmothy Christian Reece | Family Medicine | 1600 W Holland Ave, Suite 202, White Hall, AR 71602-9636 | 2007-05-02 |
| 1225188121 | Timothee Trevevant Wilkin | Family Medicine | 8608 Dollarway Rd Ste C, White Hall, AR 71602-2814 | 2007-01-11 |
| 1780641274 | R Douglas Coleman | Family Medicine | 1400 Claud Rd, White Hall, AR 71602 | 2006-04-27 |
| 1902888720 | John E. Harris | Family Medicine | 7500 Dollarway Rd, Suite 104, White Hall, AR 71602-3027 | 2005-11-17 |
| 1386637221 | Paul Wayne Davis | Family Medicine | 7400 Dollarway Rd, Ste A, White Hall, AR 71602-3025 | 2005-08-25 |
| 1134734049 | Primary Care 360 | Family Medicine | 103 Frankie Ln, White Hall, AR 71602-2685 | 2020-09-09 |
| 1144885047 | Jefferson Hospital Association, Inc. | Family Medicine | 1600 W Holland Ave Ste 202, White Hall, AR 71602-9221 | 2019-05-06 |
| 1972730919 | Family Medicine of White Hall, P.a. | Family Medicine | 1600 W Holland Ave, Suite 202, White Hall, AR 71602-9636 | 2009-06-17 |
| Find all providers in WHITE HALL | ||||
| City | WHITE HALL |
| Zip Code | 71602 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.