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Individual

THAYER STARR PHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1501 N WILLIAMSON AVE, WINSLOW, AZ 86047-2735
(928) 289-4691
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01098090A
IN
207P00000X
Emergency Medicine Physician
75374
AZ
207P00000X
Emergency Medicine Physician
Primary
DR.0053427
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09892
LA
Enumeration date
05/25/2007
Last updated
12/10/2025
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