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NPI 1578515458

NPI 1578515458 : WILLIAM L PHELPS II M.D. : GREEN VALLEY, AZ

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General NPI Number Information
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    NPI Number           |    1578515458
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM L PHELPS II M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/17/2006
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    Last Update Date     |    11/13/2007
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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                  |    520-625-2997
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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            |    520-625-2950
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    Fax                  |    520-625-2997
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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        |    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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