Provider Demographics
NPI:1285601260
Name:PHIPPS, WILLIAM JAMES JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:PHIPPS
Suffix:JR
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 1:5609 CLAIBORNE RD
Mailing Address - Street 2:
Mailing Address - City:SUTHERLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23885-9303
Mailing Address - Country:US
Mailing Address - Phone:804-265-5211
Mailing Address - Fax:804-265-2707
Practice Address - Street 1:5609 CLAIBORNE RD
Practice Address - Street 2:
Practice Address - City:SUTHERLAND
Practice Address - State:VA
Practice Address - Zip Code:23885-9303
Practice Address - Country:US
Practice Address - Phone:804-265-5211
Practice Address - Fax:804-265-2707
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041502207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5636256Medicaid
VA100630OtherANTHEM
VA45881OtherSENTARA
VA828664OtherOPTIMUM CHOICE
VA577254OtherAETNA
VA815004OtherSOUTHERN HEALTH
VA5636256Medicaid