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NPI 1336109412

NPI 1336109412 : GREGORY L. PHELPS M.D. : CHATTANOOGA, TN

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General NPI Number Information
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    NPI Number           |    1336109412
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    Entity Type          |    Individual 
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    Provider Name        |    GREGORY L. PHELPS M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2006
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    Last Update Date     |    06/07/2016
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Provider Practice Location Address
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    Address Line         |    4411 OAKWOOD DR 
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    City                 |    CHATTANOOGA
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    State                |    TN
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    Zip                  |    37416-2367
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    Country              |    US
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    Telephone            |    423-892-4289
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    Fax                  |    423-553-1818
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Provider Business Mailing Address
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    Address Line         |    4411 OAKWOOD DR 
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    City                 |    CHATTANOOGA
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    State                |    TN
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    Zip                  |    37416-2367
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    Country              |    US
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    Telephone            |    423-892-4289
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    Fax                  |    423-553-1818
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207QH0002X
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    Taxonomy Name        |    Hospice and Palliative Medicine (Family Medicine) Physician
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    License Number       |    MD027356
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MD027356
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    License Number State |    TN
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Taxonomy #3
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    Taxonomy Code        |    2083X0100X
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    Taxonomy Name        |    Occupational Medicine Physician
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    License Number       |    MD027356
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    License Number State |    TN
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