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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
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TN 7126
No 332B00000X - Durable Medical Equipment & Medical Supplies TN 7126