Individual
DR. DEREK MICHAEL PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4901005485
MI
152W00000X
Optometrist
OPT.006797
OH
152W00000X
Optometrist
Primary
OPT002423
AZ
Other
Enumeration date
06/26/2019
Last updated
03/20/2025
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