Provider Demographics
NPI:1194792143
Name:STIFF, PHILIP CECIL JR (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:CECIL
Last Name:STIFF
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3949 SUNFOREST CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4473
Mailing Address - Country:US
Mailing Address - Phone:419-292-0839
Mailing Address - Fax:419-292-0883
Practice Address - Street 1:3949 SUNFOREST CT
Practice Address - Street 2:SUITE 204
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4473
Practice Address - Country:US
Practice Address - Phone:419-292-0839
Practice Address - Fax:419-292-0883
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-10-22
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Provider Licenses
StateLicense IDTaxonomies
OH35-04-1672207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0778912Medicaid
OH0778912Medicaid
OH0651651Medicare PIN