| Doctor Name: | JARROD DUANE PHELPS |
| NPI Number: | 1265692651 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | |
| Business Practice Address: | 122 4th Ave Grinnell, IA - 501121829 |
| Business Phone Number: | 6412364323 |
| Business Fax Number: | 6412363411 |
| Mailing Address: | 122 4th Ave, GRINNELL |
| State: | IA |
| Postal Code: | 501121829 |
| Phone Number: | 6412364323 |
| Fax Number: | 6412363411 |
| NPI Enumeration Date: | 06/10/2008 |
| NPI Last Update Date: | 06/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |