Basic Information
Provider Information
NPI: 1790751329
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PHILLIPS
FirstName: REBECCA
MiddleName: PLUMLEE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 83
Address2:  
City: CORNING
State: AR
PostalCode: 724220083
CountryCode: US
TelephoneNumber: 8708573334
FaxNumber: 8708579934
Practice Location
Address1: 172 HIGHWAY 62 W
Address2:  
City: SALEM
State: AR
PostalCode: 725768059
CountryCode: US
TelephoneNumber: 8708952735
FaxNumber: 8708952709
Other Information
ProviderEnumerationDate: 02/24/2006
LastUpdateDate: 08/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XE1197ARY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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