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Individual
JAYSON B. PHELPS
Active
Individual
JAYSON B. PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001006
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10042144
—
GA
01
—
2701740
EVERCARE
GA
05
—
322061
—
GA
01
—
581994261
UNITED HEALTHCARE
GA
01
—
7595720
AETNA
GA
05
—
82974624A
—
GA
05
—
829746724A
—
GA
05
—
829746724B
—
GA
05
—
829746724O
—
GA
Enumeration date
01/30/2006
Last updated
01/02/2019
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