Provider Demographics
NPI:1144724170
Name:PHILLIPS, JAMES EDGAR II (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDGAR
Last Name:PHILLIPS
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3515 MASSILLON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7854
Mailing Address - Country:US
Mailing Address - Phone:234-271-3353
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:133 WILBUR DR NE
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1641
Practice Address - Country:US
Practice Address - Phone:330-494-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014532207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine