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Provider Information for 1619986791



DR. PHILLIP PALMER SHIPP IV DDS

Gender: MALE

Individual NPI: 1619986791

Calendar Last Updated: 2019-04-04

Details

Name Value
NPI 1619986791
Enumeration Date 2006-08-06
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 4515 HARDING RD SUITE 312
NASHVILLE, TN 37205
United States

Phone: 615-292-4100 | Fax: 615-292-4181
View Map External Link
Primary Practice Address 4515 HARDING RD SUITE 312
NASHVILLE, TN 37205
United States

Phone: 615-292-4100 | Fax: 615-292-4181
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TN 7126
No 332B00000X - Durable Medical Equipment & Medical Supplies TN 7126
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location