Provider Demographics
NPI:1437107307
Name:MCPHELAN, JAMES K (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:K
Last Name:MCPHELAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4665 E CACTUS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7703
Mailing Address - Country:US
Mailing Address - Phone:602-953-3850
Mailing Address - Fax:602-953-9257
Practice Address - Street 1:4665 E CACTUS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7703
Practice Address - Country:US
Practice Address - Phone:602-953-3850
Practice Address - Fax:602-953-9257
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ151152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist