Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME126152 | FL |
Y | 208600000X | Surgeon | ME126152 | FL |
N | 2082S0105X | Plastic Hand Surgeon | ME126152 | FL |
N | 2086S0122X | Plastic and Reconstructive Surgery | 44200-020 | WI |
N | 2086S0122X | Plastic and Reconstructive Surgery | 44541 | MN |
NPI | 1679546402 |
---|---|
Provider Name | James W Fletcher |
First Address | Fort Lauderdale, FL 33304-3579 |
Second Address | Fort Lauderdale, FL 33304-3579 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 14/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
327501900 | (05) | MN |
G81318 | (02) |