Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Dean Phillips Jr., MD

Individual provider Family Medicine Physician · NPI 1053383281

Kenneth Dean Phillips Jr., MD is a Family Practice in Cape Girardeau, Missouri. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 1991, 35 years ago. Practices with Ch Specialty Services Mo LLC, a 107-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
35
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
MO
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

8 Doctors Park
Cape Girardeau, MO 63703-4928
Phone: (573) 651-1333
Fax: (573) 651-1324
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 106690 (MO)

Record details

NPI number1053383281
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedFebruary 2, 2006
Last updated in NPPESMarch 29, 2021
Certification dateMarch 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 1991 (35 years in practice)
Group practice Ch Specialty Services Mo Llc — 107 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Cape Girardeau