Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 04-33631 | KS |
N | 207W00000X | Ophthalmologist | 00013672 | AL |
N | 207W00000X | Ophthalmologist | 0101242731 | VA |
N | 207W00000X | Ophthalmologist | 04-33631 | KS |
N | 207W00000X | Ophthalmologist | D0066849 | MD |
Y | 207W00000X | Ophthalmologist | G56961 | CA |
N | 207W00000X | Ophthalmologist | ME0052066 | FL |
NPI | 1689633638 |
---|---|
Provider Name | Dr. Donald Calvin Fletcher |
First Address | Wichita, KS 67202-3119 |
Second Address | San Francisco, CA 94115-1932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 09/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063296100 | (05) | FL |
180022165 | RAILROAD MEDICARE (01) | FL |
374440000 | (05) | FL |
A06506 | (02) | FL |
CA7010 | RAILROAD MEDICARE GROUP (01) | FL |
KA1533001 | (02) | KS |