Provider Demographics
NPI:1538514617
Name:PHILLIPS, CAROLINE CONLEY (DO)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CONLEY
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6638
Mailing Address - Country:US
Mailing Address - Phone:865-546-3998
Mailing Address - Fax:865-546-1123
Practice Address - Street 1:1975 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6638
Practice Address - Country:US
Practice Address - Phone:865-546-3998
Practice Address - Fax:865-546-1123
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46312080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty