Provider Demographics
NPI:1194806687
Name:SCHLEY, PHILIP T (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:T
Last Name:SCHLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 18TH AVE.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1251
Mailing Address - Country:US
Mailing Address - Phone:706-322-7222
Mailing Address - Fax:
Practice Address - Street 1:2808 18TH AVE,
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1251
Practice Address - Country:US
Practice Address - Phone:229-353-6208
Practice Address - Fax:229-353-7722
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007888208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA007888OtherLICENSE NUMBER