Individual
J.RUSSELL PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2345 E UNIVERSITY DR STE 1, MESA, AZ 85213-8325
(480) 834-8005
(480) 834-5624
Mailing address
2345 E UNIVERSITY DR STE 1, MESA, AZ 85213-8325
(480) 834-8005
(480) 834-5624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1216
AZ
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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