1922044718 NPI number — DR. PHILLIP BILLINGS FLEXON MD

Table of content: DR. PHILLIP BILLINGS FLEXON MD (NPI 1922044718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922044718 NPI number — DR. PHILLIP BILLINGS FLEXON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLEXON
Provider First Name:
PHILLIP
Provider Middle Name:
BILLINGS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922044718
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 N POINT PKWY
Provider Second Line Business Mailing Address:
STE 130
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30005-5210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-206-2589
Provider Business Mailing Address Fax Number:
678-261-1713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1365 ROCK QUARRY RD STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STOCKBRIDGE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30281-5024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-740-1860
Provider Business Practice Location Address Fax Number:
678-347-2104
Provider Enumeration Date:
06/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  031737 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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