Provider Demographics
NPI:1396070686
Name:PHELPS, FRANCIS E III (DOM)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:E
Last Name:PHELPS
Suffix:III
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:410 EVERNIA ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5430
Mailing Address - Country:US
Mailing Address - Phone:561-655-6695
Mailing Address - Fax:561-655-6695
Practice Address - Street 1:410 EVERNIA ST
Practice Address - Street 2:SUITE 115
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5430
Practice Address - Country:US
Practice Address - Phone:561-655-6695
Practice Address - Fax:561-655-6695
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAP899171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC0423OtherBLUE CROSS BLUE SHIELD