Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 0101239262 | VA |
N | 207VG0400X | Gynecologist | E-5341 | AR |
Y | 207VX0000X | Obstetrician | E-5341 | AR |
NPI | 1306048251 |
---|---|
Provider Name | Dr. Dawn Marie Phelps |
First Address | Marble Falls, AR 72648-9704 |
Second Address | Harrison, AR 72601-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 27/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
168755001 | (05) | AR |