Individual
JASON PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9330 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9104
(843) 847-4782
Mailing address
1643 NW 136TH AVE STE 100, SUNRISE, FL 33323-2857
(800) 424-3672
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
86193
SC
Other
Enumeration date
05/01/2019
Last updated
12/13/2024
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