Provider Demographics
NPI:1093343915
Name:PHILLIPS, DREW PARKER (DO)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:PARKER
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-7538
Mailing Address - Country:US
Mailing Address - Phone:937-723-3245
Mailing Address - Fax:
Practice Address - Street 1:800 WAYNE ST STE 112
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3309
Practice Address - Country:US
Practice Address - Phone:740-373-4288
Practice Address - Fax:740-373-4254
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017958207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology