Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jimmie Tantillo Phelps, PSC

Individual provider Optician · NPI 1740440742

Mr. Jimmie Tantillo Phelps, PSC is an Optician in Richmond, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2008
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Practice location Address checks out

205 Geri Ln
Richmond, KY 40475-2359
Phone: (859) 623-4267
Fax: (859) 623-4249
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optician (primary) Taxonomy 156FX1800X · Licence 325 (KY)

Record details

NPI number1740440742
Entity typeIndividual (Type 1)
GenderMale
Credentials PSC
Sole proprietorYes
NPI enumeratedJune 12, 2008
Last updated in NPPESJune 12, 2008

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