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Dr. Bradley Phillips
Student in an Organized Health Care Education/Training Program in Mountain Home Afb, Idaho
NPI 1245798180

Bradley Phillips is a Student in an Organized Health Care Education/Training Program based in Mountain Home Afb, ID. Bradley Phillips practices in Mountain Home Afb, ID. The NPI Number for Bradley Phillips is 1245798180 and holds a License No. 0101270994 (Idaho).

The current practice location address for Bradley Phillips is 90 Hope Dr Bldg 6000, Mountain Home Afb, ID and can be reached out via phone at 208-828-7362 and via fax at 208-828-1916.

Location: 90 Hope Dr Bldg 6000, Mountain Home Afb, ID, 83648-1057
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245798180
Provider Name
Bradley Phillips
Credential
Provider Entity Type
Individual
Gender
Male
Address
90 Hope Dr Bldg 6000, Mountain Home Afb, ID, 83648-1057
Phone Number
208-828-7362
Fax Number
208-828-1916
Provider Enumeration Date
03/11/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
90 Hope Dr Bldg 6000
City
Mountain Home Afb
State
Idaho
Zip
83648-1062
Phone Number
208-828-7362
Fax Number
208-828-1916
person
Provider Business Mailing Address Details
Address
90 Hope Dr Bldg 6000
City
Mountain Home Afb
State
Idaho
Zip
83648-1062
Phone Number
208-828-7362
Fax Number
208-828-1916
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
0101270994 (Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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