# J RUSSELL PHELPS DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083717227
- **Authorized official:** MR. DAVID L LUCAS (BILLING DEPT)
- **Authorized official phone:** (480) 830-2054

## Contact information

- **Practice address:** 2345 E UNIVERSITY DR, STE 1, MESA, AZ 85213
- **Practice address phone:** (480) 834-8005
- **Practice address fax:** (480) 834-5624
- **Mailing address:** 2345 E UNIVERSITY DR, STE 1, MESA, AZ 85213
- **Mailing address phone:** (480) 834-8005
- **Mailing address fax:** (480) 834-5624

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208M00000X | Hospitalist Physician | 1216 | AZ | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 08/17/2008