| NPI | 1568018711 |
|---|---|
| Doing Business As | PHELPS MEDICAL GROUP BCBS PCMH |
| Entity Type | Organization |
| Authorized Contact | MARK D HARREL CEO 308-995-2211 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |