| Doctor Name: | PHILLIP ANDREW DEWEY |
| NPI Number: | 1033445093 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PAC0440 |
| Business Practice Address: | 405 W Jackson St Carbondale, IL - 629011462 |
| Business Phone Number: | 6185490721 |
| Business Fax Number: | 6185290479 |
| Mailing Address: | Po Box 1105, INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462061105 |
| Phone Number: | 6184575200 |
| Fax Number: | 6185290568 |
| NPI Enumeration Date: | 10/27/2009 |
| NPI Last Update Date: | 08/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PAC0440 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |