Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306924022 Individual Practitioner Male Practitioner

Dr. Kenneth Phillips , MD

Plastic Surgery • Lakeland, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Phillips, MD is a certified Plastic Surgery practicing in Lakeland, FL. With approximately 31 years of clinical experience since graduating from Nebraska College Of Medicine in 1995, Dr. Phillips delivers high-quality medical care to the local community at 202 LAKE MIRIAM DR UNIT 1.

Dr. Phillips accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

202 Lake Miriam Dr Unit 1

Lakeland, FL 338132180

Telephone 8664003376
Fax 8637090273
Associated Practice Facility / Clinic
🏢 Dermatological Associates Pc Facility NPI 1043211436

Medicare Profile & Education

Medical School

Nebraska College Of Medicine

Graduation Year

1995

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Lakeland, FL

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
31 Yrs +5.5 yrs vs City Avg
City Avg: 25.5 Yrs
State Avg: 29.6 Yrs
Regional Practice Density
6 Specialists

Practicing in Lakeland, FL (537 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Phillips (31 Years) 31 Yrs
Lakeland Specialty Average (25.5 Years) 25.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-06-09
Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License FL ME176103

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Nicky Gazy

Dermatology

NPI 1104311075
Niti Amin , PA-C

Physician Assistant

NPI 1114356573

Physician Assistant (Certified)

Courtney Oloughlin , PA-C

Physician Assistant

NPI 1124743125

Physician Assistant (Certified)

Dr. Timothy Lian , MD

Otolaryngology - Facial Plastic Surgery

NPI 1154355493

Doctor of Medicine (M.D.)

Hannah Leonard , PA-C

Physician Assistant

NPI 1154871887

Physician Assistant (Certified)

Alice Beard , PA-C

Physician Assistant

NPI 1164532552

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location June 09, 2026

Registered at 202 LAKE MIRIAM DR UNIT 1, LAKELAND, FL 338132180 (Tel: 8664003376)

📍
Updated Business Mailing Address June 09, 2026

Registered at 151 SOUTHHALL LN STE 300, MAITLAND, FL 327517172 (Tel: 8664003376)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 09, 2026

Plastic Surgery (License #ME176103 in FL)

📍
Updated Business Mailing Address December 03, 2021

Registered at 1800 HARRISON ST FL 7, OAKLAND, CA 946123466 (Tel: 5106256262)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2025 MORSE AVE, SACRAMENTO, CA 958252115 (Tel: 9169735000)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1800 HARRISON ST FL 7, OAKLAND, CA 946123429 (Tel: 5106256262)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as KENNETH PHILLIPS, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Plastic Surgery (License #A75725 in CA)

🟢
Initial NPI Registration & Enumeration November 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306924022
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 01, 2006
Last Update: June 09, 2026
Sole Proprietor: No

Mailing Address

151 Southhall Ln Ste 300

Maitland, FL 327517172

Phone: 8664003376

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.