Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LUCAS PHILLIPS, MED, ATC, LAT
ActiveLUCAS PHILLIPS, MED, ATC, LAT is a Sports Medicine (PM&R) healthcare provider located in BLOOMINGTON, Indiana. NPI 1275819443 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · BLOOMINGTON, IN
Registration Details
- NPI Number
- 1275819443
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 1, 2011 (14.759610901337 yrs)
- Last Updated
- Mar 27, 2018
- Licenses
-
36001524A (IN)3982 (OH)
Practice Information
- Address
-
1001 E 17TH STBLOOMINGTON, IN, 474081590Browse IN providers · Browse ZIP 47408
- Phone
- 8128557916
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
- Additional Specialty
- Sports Medicine (PM&R)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.