| Doctor Name: | PHILLIP PAUL SEDRISH |
| NPI Number: | 1992864128 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD, FACR |
| License Number: | |
| Business Practice Address: | 1051 Gause Blvd # 440 Slidell, LA - 704582951 |
| Business Phone Number: | 9852806770 |
| Business Fax Number: | 9852806771 |
| Mailing Address: | 1001 Gause Blvd # 75, SLIDELL |
| State: | LA |
| Postal Code: | 704582939 |
| Phone Number: | 9852803609 |
| Fax Number: | 9852808875 |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 11/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |