| Doctor Name: | DR. PHILLIP EARL WASHBURN |
| NPI Number: | 1568677565 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 8633 |
| Business Practice Address: | 819 E Dewey Ave Sapulpa, OK - 740664458 |
| Business Phone Number: | 9185128090 |
| Business Fax Number: | |
| Mailing Address: | 101 E Lee Ave, SAPULPA |
| State: | OK |
| Postal Code: | 740664215 |
| Phone Number: | 9185128090 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2007 |
| NPI Last Update Date: | 05/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 8633 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |