Provider Demographics
NPI:1801992813
Name:PHILLIPS, KAREN GALE (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:GALE
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:GALE
Other - Last Name:FIFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17310 WRIGHT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2405
Mailing Address - Country:US
Mailing Address - Phone:833-228-6889
Mailing Address - Fax:877-853-0376
Practice Address - Street 1:26915 N 162ND ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85262-7956
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161612085R0202X
GUMTL-2023-0322085R0202X
GUM-24202085R0202X
MO20210420242085R0202X
ND161612085R0202X
OH35.0804252085R0202X
NVSP2532085R0202X
AZ381162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology