Provider Demographics
NPI:1396706594
Name:PHILLIPS, DENISE W (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:W
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:W
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1720 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 703
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1404
Mailing Address - Country:US
Mailing Address - Phone:859-260-6348
Mailing Address - Fax:859-260-4350
Practice Address - Street 1:1720 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 703
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1404
Practice Address - Country:US
Practice Address - Phone:859-260-6348
Practice Address - Fax:859-260-4350
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39256207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYI31097Medicare UPIN