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

Kenneth Phillips, MD

Individual provider Plastic Surgery Physician · NPI 1306924022

Kenneth Phillips, MD is a Plastic and Reconstructive Surgery in Lakeland, Florida. Graduated from Nebraska College of Medicine in 1995, 31 years ago. Accepts Medicare assignment. Licensed in Florida.

Years since qualifying
31
Trained at
Nebraska College of Medicine
Licensed in
FL
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

202 Lake Miriam Dr Unit 1
Lakeland, FL 33813-2180
Phone: (866) 400-3376
Fax: (863) 709-0273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence ME176103 (FL)

Record details

NPI number1306924022
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 1, 2006
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026
Mailing address151 Southhall Ln Ste 300, Maitland, FL 32751-7172

Medicare enrollment

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

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolNEBRASKA COLLEGE OF MEDICINE
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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