J RUSSELL PHELPS DO PC
Osteopathic Medicine at University Dr, Mesa, AZ

License number
Arizona 1216
Category
Osteopathic Medicine
Type
Hospitalist
Owner
Name: MR. DAVID L LUCAS
Title: BILLING DEPT
Phone: (480) 830-2054
Address
Address
2345 E University Dr STE 1, Mesa, AZ 85213
National Provider ID: 1083717227
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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J. RUSSELL PHELPS, D.O., PC

2034 N Lindsay, Mesa, AZ 85213

Registration:
Oct 29, 1986
State ID:
-0190289-5
Expiration:
PERPETUAL
President:
J Russell Phelps (President), 2034 N Lindsay Rd, Mesa, AZ 85213 (Physical)
Agent:
Sterling R Threet,2345 E University Dr #2, Mesa, AZ 85213 (Physical)
Business type:
HEALTH CARE

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