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

Stacey Philip

Individual provider Physician Assistant · NPI 1679988059

Stacey Philip is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2014, 12 years ago. Practices with Montefiore Medical Center, a 2,796-clinician group. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2014
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Practice location Address checks out

766 Walther Rd Ste 100
Lawrenceville, GA 30046-8765
Phone: (678) 312-9100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (GA)

Record details

NPI number1679988059
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 24, 2014
Last updated in NPPESJune 24, 2014
Mailing address766 Walther Rd Ste 100, Lawrenceville, GA 30046-8765

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Montefiore Medical Center — 2796 clinicians
Accepts Medicare assignment Not indicated

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