Phelps, Russell T.

Phelps, Russell T. is an individual health care provider with primary practice located at 4600 Ambassador Caffery Pkwy , Lafayette LA 70508-6902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Phelps, Russell T. can be contacted via phone (337) 521-9100.

Contact Information

Primary practice address
4600 Ambassador Caffery Pkwy Lafayette LA 70508-6902
Phone: (337) 521-9100
Fax: (337) 470-2019
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X K8421 Texas
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 303334 Louisiana

Profile Details

NPI number 1356337422
LBN Legal business name Phelps, Russell T.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated May 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356337422 NPPES
Louisiana MEDICAID 1481122
Louisiana MEDICAID 102762501

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