Individual
DR. RUSSELL T. PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 521-9100
(337) 470-2019
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(337) 521-9100
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
303334
LA
207V00000X
Obstetrics & Gynecology Physician
K8421
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102762501
—
TX
05
—
1481122
—
LA
Enumeration date
09/23/2005
Last updated
05/03/2024
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