Individual
PAUL RAYMOND PHELPS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
818 FORSYTH STREET, MACON, GA 31201-2139
(478) 633-7010
(478) 633-7585
Mailing address
P.O. BOX 28170, MACON, GA 31221-8170
(478) 254-5943
(478) 254-6093
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
011990
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00071398A
—
GA
Enumeration date
11/08/2006
Last updated
12/20/2010
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