IndividualActive
Willie Phillips, ATC
NPI 1154813756 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Charlotte, NC
Provider details
- NPI number
- 1154813756
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- License
- LAT-3766 (NC)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense LAT-3766 (NC)
Allopathic & Osteopathic Physicians
Practice location
1900 Selwyn Ave
Charlotte, NC 28274-0001
Phone: (704) 337-2405
Approximate (ZIP-level) locationGet directions
Mailing address
1900 Selwyn Ave
Charlotte, NC 28274-0001
Registry dates
- Enumerated
- 2018-05-31
- Last updated
- 2018-05-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.