Dr. John Spencer Phelps
Dentist Orthodontists
180 Stone Lake Dr
Makanda
, Illinois 62958-2730
Dr. John Spencer Phelps
Dentist Orthodontists
180 Stone Lake Dr
Makanda
, Illinois 62958-2730
(618) 549-4550
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About
Features
Specialties
- Dentist
- Orthodontists
Languages spoken
- English
Location
First Address
- Dr. John Spencer Phelps
- 180 Stone Lake Drive
- Makanda, IL
- Zip : 62958-2730
- Phone : (618) 549-4550
Second Address
- Dr. John Spencer Phelps
- 180 Stone Lake Dr
- Makanda, IL
- Zip : 62958-2730
- Phone : (618) 549-4550
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 122300000X | Dentist | 019014490 | IL |
| N | 1223X0400X | Orthodontists | 021000826 | IL |
National Provider Identifier
| NPI | 1033469036 |
|---|---|
| Provider Name | Dr. John Spencer Phelps |
| First Address | Makanda, IL 62958-2730 |
| Second Address | Makanda, IL 62958-2730 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/09/2012 |
| Last Update Date | 17/09/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.