IndividualActive
Bradley Phillips
NPI 1245798180 · Pediatrics Physician · Mountain Home Afb, ID
Provider details
- NPI number
- 1245798180
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- M-17656 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
90 Hope Dr Bldg 6000
Mountain Home Afb, ID 83648-1062
Phone: (208) 828-7362
Fax: (208) 828-1916
Approximate (ZIP-level) locationGet directions
Mailing address
90 Hope Dr
Mountain Home Afb, ID 83648-1057
Additional practice locations (1)
- 190 E Bannock StBoise, ID 83712-6241Phone: (208) 381-2645Fax: (208) 381-7170
Registry dates
- Enumerated
- 2019-03-11
- Last updated
- 2026-03-03
- Certified
- 2026-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.