Individual
TAYLOR SHAUN PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
665 DULUTH HWY, SUITE 401, LAWRENCEVILLE, GA 30046-3328
(678) 312-4077
Mailing address
650 W 42ND ST APT 1527, NEW YORK, NY 10036-4371
(478) 919-5420
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
309854
NY
207W00000X
Ophthalmology Physician
333840
LA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
309854
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
02/21/2023
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