Provider Demographics
NPI:1427691609
Name:SAMMONS, PHILLIP ANTHONY
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:ANTHONY
Last Name:SAMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2104
Mailing Address - Country:US
Mailing Address - Phone:304-521-4365
Mailing Address - Fax:513-322-9072
Practice Address - Street 1:1204 WINCHESTER RD STE 175
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4172
Practice Address - Country:US
Practice Address - Phone:859-233-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist