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General NPI Number Information
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NPI Number | 1063464014
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Entity Type | Organization
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Legal Business Name | WILLIAM L. PHELPS II MD PC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 101 W. DUVAL RD. SUITE 101
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-5280
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Country | US
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Telephone | 520-625-2950
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W. DUVAL RD. SUITE 101
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-5280
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM LEE PHELPS
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Credential | M.D.
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Telephone | 520-625-2950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 24727
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License Number State | AZ
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